|
MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH CC
|
Facility
|
IP
|
$27,901.39
|
|
|
Service Code
|
MSDRG 289
|
| Min. Negotiated Rate |
$10,327.39 |
| Max. Negotiated Rate |
$27,901.39 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,742.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,771.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,742.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,991.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,412.58
|
| Rate for Payer: GEHA Medicare |
$16,412.58
|
| Rate for Payer: Humana ChoiceCare |
$18,053.84
|
| Rate for Payer: Humana Medicare Advantage |
$16,412.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,573.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,991.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,412.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,901.39
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,977.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,991.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,412.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,469.99
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,084.33
|
| Rate for Payer: United Healthcare Commercial |
$10,753.09
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,991.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,412.58
|
| Rate for Payer: Zelis Medicare |
$13,950.69
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,327.39
|
|
|
MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC
|
Facility
|
IP
|
$48,336.83
|
|
|
Service Code
|
MSDRG 288
|
| Min. Negotiated Rate |
$14,283.85 |
| Max. Negotiated Rate |
$48,336.83 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,283.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$22,125.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,283.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25,477.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$28,433.43
|
| Rate for Payer: GEHA Medicare |
$28,433.43
|
| Rate for Payer: Humana ChoiceCare |
$31,276.77
|
| Rate for Payer: Humana Medicare Advantage |
$28,433.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$47,768.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25,477.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$28,433.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$48,336.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$39,806.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25,477.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$28,433.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$40,659.80
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27,864.76
|
| Rate for Payer: United Healthcare Commercial |
$18,628.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25,477.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28,433.43
|
| Rate for Payer: Zelis Medicare |
$24,168.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,891.33
|
|
|
MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$17,324.44
|
|
|
Service Code
|
MSDRG 290
|
| Min. Negotiated Rate |
$5,455.45 |
| Max. Negotiated Rate |
$17,324.44 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,455.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,929.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,455.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,892.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,190.85
|
| Rate for Payer: GEHA Medicare |
$10,190.85
|
| Rate for Payer: Humana ChoiceCare |
$11,209.93
|
| Rate for Payer: Humana Medicare Advantage |
$10,190.85
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,120.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,892.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,190.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,324.44
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,267.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,892.37
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,190.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,572.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,987.03
|
| Rate for Payer: United Healthcare Commercial |
$6,676.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,892.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,190.85
|
| Rate for Payer: Zelis Medicare |
$8,662.22
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,412.45
|
|
|
MS-DRG 42.00: ACUTE LEUKEMIA WITH CC
|
Facility
|
IP
|
$37,797.07
|
|
|
Service Code
|
MSDRG 835
|
| Min. Negotiated Rate |
$13,990.15 |
| Max. Negotiated Rate |
$37,797.07 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$20,737.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,300.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$20,737.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$36,869.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,233.57
|
| Rate for Payer: GEHA Medicare |
$22,233.57
|
| Rate for Payer: Humana ChoiceCare |
$24,456.93
|
| Rate for Payer: Humana Medicare Advantage |
$22,233.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,352.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$36,869.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,233.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,797.07
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,127.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$36,869.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,233.57
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,794.01
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,788.90
|
| Rate for Payer: United Healthcare Commercial |
$14,566.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$36,869.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,233.57
|
| Rate for Payer: Zelis Medicare |
$18,898.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,990.15
|
|
|
MS-DRG 42.00: ACUTE LEUKEMIA WITH MCC
|
Facility
|
IP
|
$97,811.49
|
|
|
Service Code
|
MSDRG 834
|
| Min. Negotiated Rate |
$31,825.15 |
| Max. Negotiated Rate |
$97,811.49 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$31,825.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$44,771.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$31,825.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$56,443.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$57,536.17
|
| Rate for Payer: GEHA Medicare |
$57,536.17
|
| Rate for Payer: Humana ChoiceCare |
$63,289.79
|
| Rate for Payer: Humana Medicare Advantage |
$57,536.17
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$96,660.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$56,443.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$57,536.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$97,811.49
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$80,550.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$56,443.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$57,536.17
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$82,276.72
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$56,385.45
|
| Rate for Payer: United Healthcare Commercial |
$37,696.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$56,443.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$57,536.17
|
| Rate for Payer: Zelis Medicare |
$48,905.74
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$36,203.82
|
|
|
MS-DRG 42.00: ACUTE LEUKEMIA WITH OTHER PROCEDURES
|
Facility
|
IP
|
$163,014.41
|
|
|
Service Code
|
MSDRG 850
|
| Min. Negotiated Rate |
$33,678.40 |
| Max. Negotiated Rate |
$163,014.41 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$33,678.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$74,616.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$33,678.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$59,715.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$95,890.83
|
| Rate for Payer: GEHA Medicare |
$95,890.83
|
| Rate for Payer: Humana ChoiceCare |
$105,479.91
|
| Rate for Payer: Humana Medicare Advantage |
$95,890.83
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$161,096.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$59,715.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$95,890.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$163,014.41
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$134,247.16
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$59,715.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$95,890.83
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$137,123.89
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$93,973.01
|
| Rate for Payer: United Healthcare Commercial |
$62,825.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$59,715.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$95,890.83
|
| Rate for Payer: Zelis Medicare |
$81,507.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$60,337.94
|
|
|
MS-DRG 42.00: ACUTE LEUKEMIA WITHOUT CC/MCC
|
Facility
|
IP
|
$49,261.75
|
|
|
Service Code
|
MSDRG 836
|
| Min. Negotiated Rate |
$8,323.08 |
| Max. Negotiated Rate |
$49,261.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27,756.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,292.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27,756.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$49,261.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,227.28
|
| Rate for Payer: GEHA Medicare |
$13,227.28
|
| Rate for Payer: Humana ChoiceCare |
$14,550.01
|
| Rate for Payer: Humana Medicare Advantage |
$13,227.28
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,221.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49,261.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,227.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,486.38
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,518.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49,261.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,227.28
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,915.01
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,962.73
|
| Rate for Payer: United Healthcare Commercial |
$8,666.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49,261.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,227.28
|
| Rate for Payer: Zelis Medicare |
$11,243.19
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,323.08
|
|
|
MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITH CC/MCC
|
Facility
|
IP
|
$20,584.06
|
|
|
Service Code
|
MSDRG 121
|
| Min. Negotiated Rate |
$2,481.15 |
| Max. Negotiated Rate |
$20,584.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,481.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,421.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,481.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,641.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,108.27
|
| Rate for Payer: GEHA Medicare |
$12,108.27
|
| Rate for Payer: Humana ChoiceCare |
$13,319.10
|
| Rate for Payer: Humana Medicare Advantage |
$12,108.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,341.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,641.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,108.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,584.06
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,951.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,641.72
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,108.27
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,314.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,866.10
|
| Rate for Payer: United Healthcare Commercial |
$7,933.02
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,641.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,108.27
|
| Rate for Payer: Zelis Medicare |
$10,292.03
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,618.96
|
|
|
MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,907.28
|
|
|
Service Code
|
MSDRG 122
|
| Min. Negotiated Rate |
$1,768.20 |
| Max. Negotiated Rate |
$12,907.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,768.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,494.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,768.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,383.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,592.52
|
| Rate for Payer: GEHA Medicare |
$7,592.52
|
| Rate for Payer: Humana ChoiceCare |
$8,351.77
|
| Rate for Payer: Humana Medicare Advantage |
$7,592.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,755.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,383.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,592.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,907.28
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,629.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,383.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,592.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,857.30
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,440.67
|
| Rate for Payer: United Healthcare Commercial |
$4,626.01
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,383.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,592.52
|
| Rate for Payer: Zelis Medicare |
$6,453.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,442.86
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC
|
Facility
|
IP
|
$20,417.15
|
|
|
Service Code
|
MSDRG 281
|
| Min. Negotiated Rate |
$6,037.79 |
| Max. Negotiated Rate |
$20,417.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,417.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,466.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,417.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,417.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,684.84
|
| Rate for Payer: GEHA Medicare |
$9,684.84
|
| Rate for Payer: Humana ChoiceCare |
$10,653.32
|
| Rate for Payer: Humana Medicare Advantage |
$9,684.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,270.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,417.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,684.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,464.23
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,558.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,417.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,684.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,849.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,491.14
|
| Rate for Payer: United Healthcare Commercial |
$6,286.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,417.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,684.84
|
| Rate for Payer: Zelis Medicare |
$8,232.11
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,037.79
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC
|
Facility
|
IP
|
$29,046.34
|
|
|
Service Code
|
MSDRG 280
|
| Min. Negotiated Rate |
$10,751.17 |
| Max. Negotiated Rate |
$29,046.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,631.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,295.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,631.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22,560.54
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,086.08
|
| Rate for Payer: GEHA Medicare |
$17,086.08
|
| Rate for Payer: Humana ChoiceCare |
$18,794.69
|
| Rate for Payer: Humana Medicare Advantage |
$17,086.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,704.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22,560.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,086.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,046.34
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,920.51
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22,560.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,086.08
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,433.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,744.36
|
| Rate for Payer: United Healthcare Commercial |
$11,194.35
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22,560.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,086.08
|
| Rate for Payer: Zelis Medicare |
$14,523.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,751.17
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC
|
Facility
|
IP
|
$16,462.18
|
|
|
Service Code
|
MSDRG 282
|
| Min. Negotiated Rate |
$4,749.40 |
| Max. Negotiated Rate |
$16,462.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,177.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,873.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,177.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,462.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,994.66
|
| Rate for Payer: GEHA Medicare |
$7,994.66
|
| Rate for Payer: Humana ChoiceCare |
$8,794.13
|
| Rate for Payer: Humana Medicare Advantage |
$7,994.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,431.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,462.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,994.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,590.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,192.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,462.18
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,994.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,432.36
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,834.77
|
| Rate for Payer: United Healthcare Commercial |
$4,945.18
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,462.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,994.66
|
| Rate for Payer: Zelis Medicare |
$6,795.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,749.40
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC
|
Facility
|
IP
|
$16,481.33
|
|
|
Service Code
|
MSDRG 284
|
| Min. Negotiated Rate |
$4,853.55 |
| Max. Negotiated Rate |
$16,481.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,187.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,002.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,187.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,481.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,131.29
|
| Rate for Payer: GEHA Medicare |
$8,131.29
|
| Rate for Payer: Humana ChoiceCare |
$8,944.42
|
| Rate for Payer: Humana Medicare Advantage |
$8,131.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,660.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,481.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,131.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,823.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,383.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,481.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,131.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,627.74
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,968.66
|
| Rate for Payer: United Healthcare Commercial |
$5,053.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,481.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,131.29
|
| Rate for Payer: Zelis Medicare |
$6,911.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,853.55
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC
|
Facility
|
IP
|
$34,602.87
|
|
|
Service Code
|
MSDRG 283
|
| Min. Negotiated Rate |
$11,044.25 |
| Max. Negotiated Rate |
$34,602.87 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,044.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,838.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,044.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,758.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,354.63
|
| Rate for Payer: GEHA Medicare |
$20,354.63
|
| Rate for Payer: Humana ChoiceCare |
$22,390.09
|
| Rate for Payer: Humana Medicare Advantage |
$20,354.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,195.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,758.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,354.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,602.87
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,496.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,758.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,354.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,107.12
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,947.54
|
| Rate for Payer: United Healthcare Commercial |
$13,335.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,758.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,354.63
|
| Rate for Payer: Zelis Medicare |
$17,301.44
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,807.87
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC
|
Facility
|
IP
|
$13,798.54
|
|
|
Service Code
|
MSDRG 285
|
| Min. Negotiated Rate |
$3,677.17 |
| Max. Negotiated Rate |
$13,798.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,668.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,547.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,668.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,798.54
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,588.03
|
| Rate for Payer: GEHA Medicare |
$6,588.03
|
| Rate for Payer: Humana ChoiceCare |
$7,246.83
|
| Rate for Payer: Humana Medicare Advantage |
$6,588.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,067.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,798.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,588.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,199.65
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9,223.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,798.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,588.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9,420.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,456.27
|
| Rate for Payer: United Healthcare Commercial |
$3,828.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,798.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,588.03
|
| Rate for Payer: Zelis Medicare |
$5,599.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,677.17
|
|
|
MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$40,329.32
|
|
|
Service Code
|
MSDRG 614
|
| Min. Negotiated Rate |
$9,878.75 |
| Max. Negotiated Rate |
$40,329.32 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,878.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,459.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,878.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,701.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,723.13
|
| Rate for Payer: GEHA Medicare |
$23,723.13
|
| Rate for Payer: Humana ChoiceCare |
$26,095.44
|
| Rate for Payer: Humana Medicare Advantage |
$23,723.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,854.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,701.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,723.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40,329.32
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$33,212.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,701.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,723.13
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,924.08
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,248.67
|
| Rate for Payer: United Healthcare Commercial |
$15,542.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,701.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,723.13
|
| Rate for Payer: Zelis Medicare |
$20,164.66
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,927.45
|
|
|
MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$25,358.49
|
|
|
Service Code
|
MSDRG 615
|
| Min. Negotiated Rate |
$8,020.95 |
| Max. Negotiated Rate |
$25,358.49 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,020.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,607.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,020.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,421.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,916.76
|
| Rate for Payer: GEHA Medicare |
$14,916.76
|
| Rate for Payer: Humana ChoiceCare |
$16,408.44
|
| Rate for Payer: Humana Medicare Advantage |
$14,916.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,060.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,421.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,916.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,358.49
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,883.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,421.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,916.76
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,330.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,618.42
|
| Rate for Payer: United Healthcare Commercial |
$9,773.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,421.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,916.76
|
| Rate for Payer: Zelis Medicare |
$12,679.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,386.15
|
|
|
MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$20,150.54
|
|
|
Service Code
|
MSDRG 560
|
| Min. Negotiated Rate |
$3,302.95 |
| Max. Negotiated Rate |
$20,150.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,302.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,223.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,302.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,092.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,853.26
|
| Rate for Payer: GEHA Medicare |
$11,853.26
|
| Rate for Payer: Humana ChoiceCare |
$13,038.59
|
| Rate for Payer: Humana Medicare Advantage |
$11,853.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,913.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,092.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,853.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,150.54
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,594.56
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,092.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,853.26
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,950.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,616.19
|
| Rate for Payer: United Healthcare Commercial |
$7,765.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,092.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,853.26
|
| Rate for Payer: Zelis Medicare |
$10,075.27
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,458.48
|
|
|
MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$32,849.20
|
|
|
Service Code
|
MSDRG 559
|
| Min. Negotiated Rate |
$5,317.20 |
| Max. Negotiated Rate |
$32,849.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,317.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,036.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,317.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,648.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,323.06
|
| Rate for Payer: GEHA Medicare |
$19,323.06
|
| Rate for Payer: Humana ChoiceCare |
$21,255.37
|
| Rate for Payer: Humana Medicare Advantage |
$19,323.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,462.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,648.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,323.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,849.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,052.28
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,648.32
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,323.06
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,631.98
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,936.60
|
| Rate for Payer: United Healthcare Commercial |
$12,659.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,648.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,323.06
|
| Rate for Payer: Zelis Medicare |
$16,424.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,158.76
|
|
|
MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$14,942.13
|
|
|
Service Code
|
MSDRG 561
|
| Min. Negotiated Rate |
$1,943.55 |
| Max. Negotiated Rate |
$14,942.13 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,943.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,622.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,943.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,692.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,789.49
|
| Rate for Payer: GEHA Medicare |
$8,789.49
|
| Rate for Payer: Humana ChoiceCare |
$9,668.44
|
| Rate for Payer: Humana Medicare Advantage |
$8,789.49
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,766.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,692.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,789.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,942.13
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,305.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,692.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,789.49
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,568.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,613.70
|
| Rate for Payer: United Healthcare Commercial |
$5,576.03
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,692.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,789.49
|
| Rate for Payer: Zelis Medicare |
$7,471.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,355.28
|
|
|
MS-DRG 42.00: AFTERCARE WITH CC/MCC
|
Facility
|
IP
|
$19,094.04
|
|
|
Service Code
|
MSDRG 949
|
| Min. Negotiated Rate |
$3,132.85 |
| Max. Negotiated Rate |
$19,094.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,132.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,739.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,132.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,792.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,231.79
|
| Rate for Payer: GEHA Medicare |
$11,231.79
|
| Rate for Payer: Humana ChoiceCare |
$12,354.97
|
| Rate for Payer: Humana Medicare Advantage |
$11,231.79
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,869.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,792.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,231.79
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,094.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,724.51
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,792.20
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,231.79
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,061.46
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,007.15
|
| Rate for Payer: United Healthcare Commercial |
$7,358.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,792.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,231.79
|
| Rate for Payer: Zelis Medicare |
$9,547.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,067.45
|
|
|
MS-DRG 42.00: AFTERCARE WITHOUT CC/MCC
|
Facility
|
IP
|
$11,560.48
|
|
|
Service Code
|
MSDRG 950
|
| Min. Negotiated Rate |
$1,775.55 |
| Max. Negotiated Rate |
$11,560.48 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,775.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,747.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,775.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,396.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,800.28
|
| Rate for Payer: GEHA Medicare |
$6,800.28
|
| Rate for Payer: Humana ChoiceCare |
$7,480.31
|
| Rate for Payer: Humana Medicare Advantage |
$6,800.28
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,424.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,396.10
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,800.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,560.48
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9,520.39
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,396.10
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,800.28
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9,724.40
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,664.27
|
| Rate for Payer: United Healthcare Commercial |
$3,997.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,396.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,800.28
|
| Rate for Payer: Zelis Medicare |
$5,780.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,838.95
|
|
|
MS-DRG 42.00: AICD GENERATOR PROCEDURES
|
Facility
|
IP
|
$86,477.16
|
|
|
Service Code
|
MSDRG 245
|
| Min. Negotiated Rate |
$17,623.55 |
| Max. Negotiated Rate |
$86,477.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$17,623.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$39,583.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$17,623.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$31,373.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$50,868.92
|
| Rate for Payer: GEHA Medicare |
$50,868.92
|
| Rate for Payer: Humana ChoiceCare |
$55,955.81
|
| Rate for Payer: Humana Medicare Advantage |
$50,868.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$85,459.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$31,373.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$50,868.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$86,477.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$71,216.49
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$31,373.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$50,868.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$72,742.56
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$49,851.54
|
| Rate for Payer: United Healthcare Commercial |
$33,327.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$31,373.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50,868.92
|
| Rate for Payer: Zelis Medicare |
$43,238.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$32,008.54
|
|
|
MS-DRG 42.00: AICD LEAD PROCEDURES
|
Facility
|
IP
|
$63,125.40
|
|
|
Service Code
|
MSDRG 265
|
| Min. Negotiated Rate |
$13,203.05 |
| Max. Negotiated Rate |
$63,125.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$13,203.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,894.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$13,203.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23,569.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$37,132.59
|
| Rate for Payer: GEHA Medicare |
$37,132.59
|
| Rate for Payer: Humana ChoiceCare |
$40,845.85
|
| Rate for Payer: Humana Medicare Advantage |
$37,132.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$62,382.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23,569.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$37,132.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$63,125.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$51,985.63
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23,569.52
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$37,132.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$53,099.60
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$36,389.94
|
| Rate for Payer: United Healthcare Commercial |
$24,328.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23,569.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37,132.59
|
| Rate for Payer: Zelis Medicare |
$31,562.70
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23,365.16
|
|
|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA
|
Facility
|
IP
|
$12,115.56
|
|
|
Service Code
|
MSDRG 894
|
| Min. Negotiated Rate |
$1,591.80 |
| Max. Negotiated Rate |
$12,115.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,591.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,055.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,591.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,071.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,126.80
|
| Rate for Payer: GEHA Medicare |
$7,126.80
|
| Rate for Payer: Humana ChoiceCare |
$7,839.48
|
| Rate for Payer: Humana Medicare Advantage |
$7,126.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,973.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,071.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,126.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,115.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9,977.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,071.72
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,126.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,191.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,984.26
|
| Rate for Payer: United Healthcare Commercial |
$4,256.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,071.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,126.80
|
| Rate for Payer: Zelis Medicare |
$6,057.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,087.86
|
|
