|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC
|
Facility
|
IP
|
$31,513.19
|
|
|
Service Code
|
MSDRG 896
|
| Min. Negotiated Rate |
$3,831.80 |
| Max. Negotiated Rate |
$31,513.19 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,831.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,424.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,831.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,026.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,537.17
|
| Rate for Payer: GEHA Medicare |
$18,537.17
|
| Rate for Payer: Humana ChoiceCare |
$20,390.89
|
| Rate for Payer: Humana Medicare Advantage |
$18,537.17
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,142.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,026.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,537.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,513.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,952.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,026.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,537.17
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,508.15
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,166.43
|
| Rate for Payer: United Healthcare Commercial |
$12,145.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,026.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,537.17
|
| Rate for Payer: Zelis Medicare |
$15,756.59
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,664.24
|
|
|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC
|
Facility
|
IP
|
$15,885.79
|
|
|
Service Code
|
MSDRG 897
|
| Min. Negotiated Rate |
$2,676.45 |
| Max. Negotiated Rate |
$15,885.79 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,676.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,145.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,676.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,986.49
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,344.58
|
| Rate for Payer: GEHA Medicare |
$9,344.58
|
| Rate for Payer: Humana ChoiceCare |
$10,279.04
|
| Rate for Payer: Humana Medicare Advantage |
$9,344.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,698.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,986.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,344.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,885.79
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,082.41
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,986.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,344.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,362.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,157.69
|
| Rate for Payer: United Healthcare Commercial |
$6,016.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,986.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,344.58
|
| Rate for Payer: Zelis Medicare |
$7,942.89
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,778.41
|
|
|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY
|
Facility
|
IP
|
$25,622.13
|
|
|
Service Code
|
MSDRG 895
|
| Min. Negotiated Rate |
$3,461.50 |
| Max. Negotiated Rate |
$25,622.13 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,461.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,727.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,461.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,372.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,071.84
|
| Rate for Payer: GEHA Medicare |
$15,071.84
|
| Rate for Payer: Humana ChoiceCare |
$16,579.02
|
| Rate for Payer: Humana Medicare Advantage |
$15,071.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,320.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,372.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,071.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,622.13
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,100.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,372.37
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,071.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,552.73
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,770.40
|
| Rate for Payer: United Healthcare Commercial |
$9,874.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,372.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,071.84
|
| Rate for Payer: Zelis Medicare |
$12,811.06
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,483.75
|
|
|
MS-DRG 42.00: ALLERGIC REACTIONS WITH MCC
|
Facility
|
IP
|
$30,753.99
|
|
|
Service Code
|
MSDRG 915
|
| Min. Negotiated Rate |
$3,202.50 |
| Max. Negotiated Rate |
$30,753.99 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,202.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,076.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,202.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,915.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,090.58
|
| Rate for Payer: GEHA Medicare |
$18,090.58
|
| Rate for Payer: Humana ChoiceCare |
$19,899.64
|
| Rate for Payer: Humana Medicare Advantage |
$18,090.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,392.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,915.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,090.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30,753.99
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,326.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,915.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,090.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$25,869.53
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,728.77
|
| Rate for Payer: United Healthcare Commercial |
$11,852.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,915.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,090.58
|
| Rate for Payer: Zelis Medicare |
$15,376.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,383.25
|
|
|
MS-DRG 42.00: ALLERGIC REACTIONS WITHOUT MCC
|
Facility
|
IP
|
$12,699.87
|
|
|
Service Code
|
MSDRG 916
|
| Min. Negotiated Rate |
$2,226.70 |
| Max. Negotiated Rate |
$12,699.87 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,226.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,379.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,226.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,192.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,470.51
|
| Rate for Payer: GEHA Medicare |
$7,470.51
|
| Rate for Payer: Humana ChoiceCare |
$8,217.56
|
| Rate for Payer: Humana Medicare Advantage |
$7,470.51
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,550.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,192.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,470.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,699.87
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,458.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,192.53
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,470.51
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,682.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,321.10
|
| Rate for Payer: United Healthcare Commercial |
$4,529.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,192.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,470.51
|
| Rate for Payer: Zelis Medicare |
$6,349.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,349.85
|
|
|
MS-DRG 42.00: ALLOGENEIC BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$231,850.39
|
|
|
Service Code
|
MSDRG 014
|
| Min. Negotiated Rate |
$69,217.05 |
| Max. Negotiated Rate |
$231,850.39 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$69,217.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$106,124.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$69,217.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$122,453.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$136,382.58
|
| Rate for Payer: GEHA Medicare |
$136,382.58
|
| Rate for Payer: Humana ChoiceCare |
$150,020.84
|
| Rate for Payer: Humana Medicare Advantage |
$136,382.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$229,122.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$122,453.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$136,382.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$231,850.39
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$190,935.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$122,453.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$136,382.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$195,027.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$133,654.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$122,453.28
|
| Rate for Payer: Zelis Medicare |
$115,925.19
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$85,816.79
|
|
|
MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC
|
Facility
|
IP
|
$51,534.48
|
|
|
Service Code
|
MSDRG 240
|
| Min. Negotiated Rate |
$11,926.60 |
| Max. Negotiated Rate |
$51,534.48 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,926.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,588.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,926.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21,316.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$30,314.40
|
| Rate for Payer: GEHA Medicare |
$30,314.40
|
| Rate for Payer: Humana ChoiceCare |
$33,345.84
|
| Rate for Payer: Humana Medicare Advantage |
$30,314.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$50,928.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21,316.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$30,314.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$51,534.48
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$42,440.16
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21,316.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$30,314.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$43,349.59
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,708.11
|
| Rate for Payer: United Healthcare Commercial |
$19,861.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21,316.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,314.40
|
| Rate for Payer: Zelis Medicare |
$25,767.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19,074.91
|
|
|
MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC
|
Facility
|
IP
|
$89,133.33
|
|
|
Service Code
|
MSDRG 239
|
| Min. Negotiated Rate |
$23,636.55 |
| Max. Negotiated Rate |
$89,133.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$23,636.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40,798.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$23,636.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41,988.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$52,431.37
|
| Rate for Payer: GEHA Medicare |
$52,431.37
|
| Rate for Payer: Humana ChoiceCare |
$57,674.51
|
| Rate for Payer: Humana Medicare Advantage |
$52,431.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$88,084.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$41,988.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$52,431.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$89,133.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73,403.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$41,988.20
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$52,431.37
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$74,976.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$51,382.74
|
| Rate for Payer: United Healthcare Commercial |
$34,351.66
|
| Rate for Payer: United Healthcare Managed Medicaid |
$41,988.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$52,431.37
|
| Rate for Payer: Zelis Medicare |
$44,566.66
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$32,991.69
|
|
|
MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC
|
Facility
|
IP
|
$26,719.29
|
|
|
Service Code
|
MSDRG 241
|
| Min. Negotiated Rate |
$8,426.60 |
| Max. Negotiated Rate |
$26,719.29 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,426.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,230.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,426.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,137.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,717.23
|
| Rate for Payer: GEHA Medicare |
$15,717.23
|
| Rate for Payer: Humana ChoiceCare |
$17,288.95
|
| Rate for Payer: Humana Medicare Advantage |
$15,717.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,404.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,137.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,717.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,719.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,004.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,137.46
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,717.23
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,475.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,402.89
|
| Rate for Payer: United Healthcare Commercial |
$10,297.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,137.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,717.23
|
| Rate for Payer: Zelis Medicare |
$13,359.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,889.84
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$38,175.74
|
|
|
Service Code
|
MSDRG 475
|
| Min. Negotiated Rate |
$8,760.50 |
| Max. Negotiated Rate |
$38,175.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,760.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,474.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,760.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,726.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,456.32
|
| Rate for Payer: GEHA Medicare |
$22,456.32
|
| Rate for Payer: Humana ChoiceCare |
$24,701.95
|
| Rate for Payer: Humana Medicare Advantage |
$22,456.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,726.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,726.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,456.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$38,175.74
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,438.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,726.91
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,456.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$32,112.54
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,007.19
|
| Rate for Payer: United Healthcare Commercial |
$14,712.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,726.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,456.32
|
| Rate for Payer: Zelis Medicare |
$19,087.87
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,130.32
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$79,361.59
|
|
|
Service Code
|
MSDRG 474
|
| Min. Negotiated Rate |
$17,590.65 |
| Max. Negotiated Rate |
$79,361.59 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$17,590.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$36,326.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$17,590.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$31,315.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$46,683.29
|
| Rate for Payer: GEHA Medicare |
$46,683.29
|
| Rate for Payer: Humana ChoiceCare |
$51,351.62
|
| Rate for Payer: Humana Medicare Advantage |
$46,683.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$78,427.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$31,315.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$46,683.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$79,361.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$65,356.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$31,315.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$46,683.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$66,757.10
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$45,749.62
|
| Rate for Payer: United Healthcare Commercial |
$30,585.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$31,315.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$46,683.29
|
| Rate for Payer: Zelis Medicare |
$39,680.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$29,374.78
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$20,582.29
|
|
|
Service Code
|
MSDRG 476
|
| Min. Negotiated Rate |
$5,241.95 |
| Max. Negotiated Rate |
$20,582.29 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,241.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,421.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,241.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,515.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,107.23
|
| Rate for Payer: GEHA Medicare |
$12,107.23
|
| Rate for Payer: Humana ChoiceCare |
$13,317.95
|
| Rate for Payer: Humana Medicare Advantage |
$12,107.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,340.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,515.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,107.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,582.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,950.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,515.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,107.23
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,313.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,865.09
|
| Rate for Payer: United Healthcare Commercial |
$7,932.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,515.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,107.23
|
| Rate for Payer: Zelis Medicare |
$10,291.15
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,618.31
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$34,181.75
|
|
|
Service Code
|
MSDRG 617
|
| Min. Negotiated Rate |
$9,119.25 |
| Max. Negotiated Rate |
$34,181.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,119.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,645.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,119.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,360.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,106.91
|
| Rate for Payer: GEHA Medicare |
$20,106.91
|
| Rate for Payer: Humana ChoiceCare |
$22,117.60
|
| Rate for Payer: Humana Medicare Advantage |
$20,106.91
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$33,779.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,360.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,106.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,181.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,149.67
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,360.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,106.91
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,752.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,704.77
|
| Rate for Payer: United Healthcare Commercial |
$13,173.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,360.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,106.91
|
| Rate for Payer: Zelis Medicare |
$17,090.87
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,651.98
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$68,395.30
|
|
|
Service Code
|
MSDRG 616
|
| Min. Negotiated Rate |
$18,415.60 |
| Max. Negotiated Rate |
$68,395.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$18,415.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$31,306.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$18,415.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$32,771.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$40,232.53
|
| Rate for Payer: GEHA Medicare |
$40,232.53
|
| Rate for Payer: Humana ChoiceCare |
$44,255.78
|
| Rate for Payer: Humana Medicare Advantage |
$40,232.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$67,590.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$32,771.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$40,232.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$68,395.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$56,325.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$32,771.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$40,232.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$57,532.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$39,427.88
|
| Rate for Payer: United Healthcare Commercial |
$26,359.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$32,771.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40,232.53
|
| Rate for Payer: Zelis Medicare |
$34,197.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$25,315.75
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$22,033.38
|
|
|
Service Code
|
MSDRG 618
|
| Min. Negotiated Rate |
$8,155.40 |
| Max. Negotiated Rate |
$22,033.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,393.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,085.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,393.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,078.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,960.81
|
| Rate for Payer: GEHA Medicare |
$12,960.81
|
| Rate for Payer: Humana ChoiceCare |
$14,256.89
|
| Rate for Payer: Humana Medicare Advantage |
$12,960.81
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,774.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,078.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,960.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,033.38
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,145.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,078.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,960.81
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,533.96
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,701.59
|
| Rate for Payer: United Healthcare Commercial |
$8,491.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,078.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,960.81
|
| Rate for Payer: Zelis Medicare |
$11,016.69
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,155.40
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH CC
|
Facility
|
IP
|
$22,277.58
|
|
|
Service Code
|
MSDRG 348
|
| Min. Negotiated Rate |
$5,290.95 |
| Max. Negotiated Rate |
$22,277.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,290.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,197.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,290.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,601.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,104.46
|
| Rate for Payer: GEHA Medicare |
$13,104.46
|
| Rate for Payer: Humana ChoiceCare |
$14,414.91
|
| Rate for Payer: Humana Medicare Advantage |
$13,104.46
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,015.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,601.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,104.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,277.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,346.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,601.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,104.46
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,739.38
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,842.37
|
| Rate for Payer: United Healthcare Commercial |
$8,585.70
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,601.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,104.46
|
| Rate for Payer: Zelis Medicare |
$11,138.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,245.80
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$41,883.04
|
|
|
Service Code
|
MSDRG 347
|
| Min. Negotiated Rate |
$9,326.80 |
| Max. Negotiated Rate |
$41,883.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,326.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,171.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,326.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,726.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,637.08
|
| Rate for Payer: GEHA Medicare |
$24,637.08
|
| Rate for Payer: Humana ChoiceCare |
$27,100.79
|
| Rate for Payer: Humana Medicare Advantage |
$24,637.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$41,390.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,726.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,637.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$41,883.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$34,491.91
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,726.62
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,637.08
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35,231.02
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,144.34
|
| Rate for Payer: United Healthcare Commercial |
$16,141.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,726.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,637.08
|
| Rate for Payer: Zelis Medicare |
$20,941.52
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,502.54
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$15,866.78
|
|
|
Service Code
|
MSDRG 349
|
| Min. Negotiated Rate |
$3,236.80 |
| Max. Negotiated Rate |
$15,866.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,236.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,135.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,236.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,975.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,333.40
|
| Rate for Payer: GEHA Medicare |
$9,333.40
|
| Rate for Payer: Humana ChoiceCare |
$10,266.74
|
| Rate for Payer: Humana Medicare Advantage |
$9,333.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,680.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,975.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,333.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,866.78
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,066.76
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,975.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,333.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,346.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,146.73
|
| Rate for Payer: United Healthcare Commercial |
$6,007.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,975.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,333.40
|
| Rate for Payer: Zelis Medicare |
$7,933.39
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,769.90
|
|
|
MS-DRG 42.00: ANGINA PECTORIS
|
Facility
|
IP
|
$13,199.45
|
|
|
Service Code
|
MSDRG 311
|
| Min. Negotiated Rate |
$3,343.55 |
| Max. Negotiated Rate |
$13,199.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,343.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,656.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,343.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,164.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,764.38
|
| Rate for Payer: GEHA Medicare |
$7,764.38
|
| Rate for Payer: Humana ChoiceCare |
$8,540.82
|
| Rate for Payer: Humana Medicare Advantage |
$7,764.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,044.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,164.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,764.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,199.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,870.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,164.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,764.38
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,103.06
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,609.09
|
| Rate for Payer: United Healthcare Commercial |
$4,762.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,164.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,764.38
|
| Rate for Payer: Zelis Medicare |
$6,599.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,573.86
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC
|
Facility
|
IP
|
$117,990.34
|
|
|
Service Code
|
MSDRG 268
|
| Min. Negotiated Rate |
$22,298.15 |
| Max. Negotiated Rate |
$117,990.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$22,298.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$54,007.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$22,298.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$39,625.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$69,406.08
|
| Rate for Payer: GEHA Medicare |
$69,406.08
|
| Rate for Payer: Humana ChoiceCare |
$76,346.69
|
| Rate for Payer: Humana Medicare Advantage |
$69,406.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$116,602.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$39,625.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$69,406.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$117,990.34
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$97,168.51
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$39,625.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$69,406.08
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$99,250.69
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$68,017.96
|
| Rate for Payer: United Healthcare Commercial |
$45,473.03
|
| Rate for Payer: United Healthcare Managed Medicaid |
$39,625.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$69,406.08
|
| Rate for Payer: Zelis Medicare |
$58,995.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$43,672.78
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
|
Facility
|
IP
|
$73,628.04
|
|
|
Service Code
|
MSDRG 269
|
| Min. Negotiated Rate |
$8,925.70 |
| Max. Negotiated Rate |
$73,628.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,925.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33,701.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,925.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,018.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$43,310.61
|
| Rate for Payer: GEHA Medicare |
$43,310.61
|
| Rate for Payer: Humana ChoiceCare |
$47,641.67
|
| Rate for Payer: Humana Medicare Advantage |
$43,310.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$72,761.82
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,018.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$43,310.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$73,628.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$60,634.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,018.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$43,310.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$61,934.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$42,444.40
|
| Rate for Payer: United Healthcare Commercial |
$28,375.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,018.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$43,310.61
|
| Rate for Payer: Zelis Medicare |
$36,814.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$27,252.58
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH CC
|
Facility
|
IP
|
$26,777.69
|
|
|
Service Code
|
MSDRG 398
|
| Min. Negotiated Rate |
$5,431.65 |
| Max. Negotiated Rate |
$26,777.69 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,431.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,256.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,431.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,850.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,751.58
|
| Rate for Payer: GEHA Medicare |
$15,751.58
|
| Rate for Payer: Humana ChoiceCare |
$17,326.74
|
| Rate for Payer: Humana Medicare Advantage |
$15,751.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,462.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,850.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,751.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,777.69
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,052.21
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,850.36
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,751.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,524.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,436.55
|
| Rate for Payer: United Healthcare Commercial |
$10,320.02
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,850.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,751.58
|
| Rate for Payer: Zelis Medicare |
$13,388.84
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,911.46
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC
|
Facility
|
IP
|
$43,847.33
|
|
|
Service Code
|
MSDRG 397
|
| Min. Negotiated Rate |
$7,334.95 |
| Max. Negotiated Rate |
$43,847.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,334.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,070.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,334.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,210.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$25,792.55
|
| Rate for Payer: GEHA Medicare |
$25,792.55
|
| Rate for Payer: Humana ChoiceCare |
$28,371.81
|
| Rate for Payer: Humana Medicare Advantage |
$25,792.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$43,331.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,210.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$25,792.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$43,847.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$36,109.57
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,210.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$25,792.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$36,883.35
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$25,276.70
|
| Rate for Payer: United Healthcare Commercial |
$16,898.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,210.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,792.55
|
| Rate for Payer: Zelis Medicare |
$21,923.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,229.59
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,886.84
|
|
|
Service Code
|
MSDRG 399
|
| Min. Negotiated Rate |
$4,015.90 |
| Max. Negotiated Rate |
$19,886.84 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,015.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,102.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,015.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,351.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,698.14
|
| Rate for Payer: GEHA Medicare |
$11,698.14
|
| Rate for Payer: Humana ChoiceCare |
$12,867.95
|
| Rate for Payer: Humana Medicare Advantage |
$11,698.14
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,652.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,351.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,698.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,886.84
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,377.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,351.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,698.14
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,728.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,464.18
|
| Rate for Payer: United Healthcare Commercial |
$7,664.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,351.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,698.14
|
| Rate for Payer: Zelis Medicare |
$9,943.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,360.89
|
|
|
MS-DRG 42.00: ARTHROSCOPY
|
Facility
|
IP
|
$31,086.69
|
|
|
Service Code
|
MSDRG 509
|
| Min. Negotiated Rate |
$4,565.75 |
| Max. Negotiated Rate |
$31,086.69 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,565.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,229.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,565.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,321.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,286.29
|
| Rate for Payer: GEHA Medicare |
$18,286.29
|
| Rate for Payer: Humana ChoiceCare |
$20,114.92
|
| Rate for Payer: Humana Medicare Advantage |
$18,286.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,720.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,321.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,286.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,086.69
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,600.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,321.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,286.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,149.39
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,920.56
|
| Rate for Payer: United Healthcare Commercial |
$11,980.69
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,321.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,286.29
|
| Rate for Payer: Zelis Medicare |
$15,543.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,506.39
|
|
