|
MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC
|
Facility
|
IP
|
$20,585.83
|
|
|
Service Code
|
MSDRG 302
|
| Min. Negotiated Rate |
$4,350.85 |
| Max. Negotiated Rate |
$20,585.83 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,350.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,422.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,350.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,942.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,109.31
|
| Rate for Payer: GEHA Medicare |
$12,109.31
|
| Rate for Payer: Humana ChoiceCare |
$13,320.24
|
| Rate for Payer: Humana Medicare Advantage |
$12,109.31
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,343.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,942.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,109.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,585.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,953.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,942.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,109.31
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,316.31
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,867.12
|
| Rate for Payer: United Healthcare Commercial |
$7,933.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,942.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,109.31
|
| Rate for Payer: Zelis Medicare |
$10,292.91
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,619.61
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC
|
Facility
|
IP
|
$12,821.13
|
|
|
Service Code
|
MSDRG 303
|
| Min. Negotiated Rate |
$3,436.30 |
| Max. Negotiated Rate |
$12,821.13 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,446.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,436.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,327.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,541.84
|
| Rate for Payer: GEHA Medicare |
$7,541.84
|
| Rate for Payer: Humana ChoiceCare |
$8,296.02
|
| Rate for Payer: Humana Medicare Advantage |
$7,541.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,670.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,327.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,541.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,821.13
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,558.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,327.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,541.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,784.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,391.00
|
| Rate for Payer: United Healthcare Commercial |
$4,585.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,327.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,541.84
|
| Rate for Payer: Zelis Medicare |
$6,410.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,404.22
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC
|
Facility
|
IP
|
$106,811.71
|
|
|
Service Code
|
MSDRG 016
|
| Min. Negotiated Rate |
$36,343.30 |
| Max. Negotiated Rate |
$106,811.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$36,343.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$48,890.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$36,343.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$64,419.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$62,830.42
|
| Rate for Payer: GEHA Medicare |
$62,830.42
|
| Rate for Payer: Humana ChoiceCare |
$69,113.46
|
| Rate for Payer: Humana Medicare Advantage |
$62,830.42
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$105,555.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$64,419.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$62,830.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$106,811.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$87,962.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$64,419.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$62,830.42
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$89,847.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$61,573.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$64,419.93
|
| Rate for Payer: Zelis Medicare |
$53,405.86
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$39,535.14
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$106,811.71
|
|
|
Service Code
|
MSDRG 017
|
| Min. Negotiated Rate |
$30,786.00 |
| Max. Negotiated Rate |
$106,811.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$30,786.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$48,890.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$30,786.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$54,609.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$62,830.42
|
| Rate for Payer: GEHA Medicare |
$62,830.42
|
| Rate for Payer: Humana ChoiceCare |
$69,113.46
|
| Rate for Payer: Humana Medicare Advantage |
$62,830.42
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$105,555.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$54,609.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$62,830.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$106,811.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$87,962.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$54,609.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$62,830.42
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$89,847.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$61,573.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$54,609.41
|
| Rate for Payer: Zelis Medicare |
$53,405.86
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$39,535.14
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
|
Facility
|
IP
|
$34,894.90
|
|
|
Service Code
|
MSDRG 519
|
| Min. Negotiated Rate |
$6,761.30 |
| Max. Negotiated Rate |
$34,894.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,761.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,972.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,761.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,197.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,526.41
|
| Rate for Payer: GEHA Medicare |
$20,526.41
|
| Rate for Payer: Humana ChoiceCare |
$22,579.05
|
| Rate for Payer: Humana Medicare Advantage |
$20,526.41
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,484.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,197.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,526.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,894.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,736.97
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,197.64
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,526.41
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,352.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,115.88
|
| Rate for Payer: United Healthcare Commercial |
$13,448.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,197.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,526.41
|
| Rate for Payer: Zelis Medicare |
$17,447.45
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,915.94
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
|
Facility
|
IP
|
$63,422.72
|
|
|
Service Code
|
MSDRG 518
|
| Min. Negotiated Rate |
$11,054.40 |
| Max. Negotiated Rate |
$63,422.72 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,054.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$29,030.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,054.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,776.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$37,307.48
|
| Rate for Payer: GEHA Medicare |
$37,307.48
|
| Rate for Payer: Humana ChoiceCare |
$41,038.23
|
| Rate for Payer: Humana Medicare Advantage |
$37,307.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$62,676.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,776.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$37,307.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$63,422.72
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$52,230.47
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,776.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$37,307.48
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$53,349.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$36,561.33
|
| Rate for Payer: United Healthcare Commercial |
$24,442.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,776.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37,307.48
|
| Rate for Payer: Zelis Medicare |
$31,711.36
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23,475.20
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$25,362.03
|
|
|
Service Code
|
MSDRG 520
|
| Min. Negotiated Rate |
$5,987.80 |
| Max. Negotiated Rate |
$25,362.03 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,987.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,608.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,987.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,832.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,918.84
|
| Rate for Payer: GEHA Medicare |
$14,918.84
|
| Rate for Payer: Humana ChoiceCare |
$16,410.72
|
| Rate for Payer: Humana Medicare Advantage |
$14,918.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,063.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,832.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,918.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,362.03
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,886.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,832.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,918.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,333.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,620.46
|
| Rate for Payer: United Healthcare Commercial |
$9,774.42
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,832.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,918.84
|
| Rate for Payer: Zelis Medicare |
$12,681.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,387.46
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC
|
Facility
|
IP
|
$42,421.00
|
|
|
Service Code
|
MSDRG 095
|
| Min. Negotiated Rate |
$12,784.10 |
| Max. Negotiated Rate |
$42,421.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,784.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,417.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,784.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22,829.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,953.53
|
| Rate for Payer: GEHA Medicare |
$24,953.53
|
| Rate for Payer: Humana ChoiceCare |
$27,448.88
|
| Rate for Payer: Humana Medicare Advantage |
$24,953.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$41,921.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22,829.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,953.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$42,421.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$34,934.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22,829.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,953.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35,683.55
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,454.46
|
| Rate for Payer: United Healthcare Commercial |
$16,348.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22,829.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,953.53
|
| Rate for Payer: Zelis Medicare |
$21,210.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,701.66
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC
|
Facility
|
IP
|
$64,567.67
|
|
|
Service Code
|
MSDRG 094
|
| Min. Negotiated Rate |
$16,703.40 |
| Max. Negotiated Rate |
$64,567.67 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,703.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$29,554.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,703.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$29,748.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$37,980.98
|
| Rate for Payer: GEHA Medicare |
$37,980.98
|
| Rate for Payer: Humana ChoiceCare |
$41,779.08
|
| Rate for Payer: Humana Medicare Advantage |
$37,980.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$63,808.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$29,748.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$37,980.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$64,567.67
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$53,173.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$29,748.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$37,980.98
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$54,312.80
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$37,221.36
|
| Rate for Payer: United Healthcare Commercial |
$24,884.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$29,748.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37,980.98
|
| Rate for Payer: Zelis Medicare |
$32,283.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23,898.99
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$42,421.00
|
|
|
Service Code
|
MSDRG 096
|
| Min. Negotiated Rate |
$9,619.75 |
| Max. Negotiated Rate |
$42,421.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,619.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,417.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,619.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,243.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,953.53
|
| Rate for Payer: GEHA Medicare |
$24,953.53
|
| Rate for Payer: Humana ChoiceCare |
$27,448.88
|
| Rate for Payer: Humana Medicare Advantage |
$24,953.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$41,921.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,243.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,953.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$42,421.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$34,934.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,243.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,953.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35,683.55
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,454.46
|
| Rate for Payer: United Healthcare Commercial |
$16,348.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,243.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,953.53
|
| Rate for Payer: Zelis Medicare |
$21,210.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,701.66
|
|
|
MS-DRG 42.00: BEHAVIORAL AND DEVELOPMENTAL DISORDERS
|
Facility
|
IP
|
$31,790.97
|
|
|
Service Code
|
MSDRG 886
|
| Min. Negotiated Rate |
$5,696.60 |
| Max. Negotiated Rate |
$31,790.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,696.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,551.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,696.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,318.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,700.57
|
| Rate for Payer: GEHA Medicare |
$18,700.57
|
| Rate for Payer: Humana ChoiceCare |
$20,570.63
|
| Rate for Payer: Humana Medicare Advantage |
$18,700.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,416.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,318.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,700.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,790.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,180.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,318.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,700.57
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,741.82
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,326.56
|
| Rate for Payer: United Healthcare Commercial |
$12,252.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,318.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,700.57
|
| Rate for Payer: Zelis Medicare |
$15,895.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,767.08
|
|
|
MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITH MCC
|
Facility
|
IP
|
$22,343.03
|
|
|
Service Code
|
MSDRG 725
|
| Min. Negotiated Rate |
$5,539.80 |
| Max. Negotiated Rate |
$22,343.03 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,539.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,539.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,041.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,142.96
|
| Rate for Payer: GEHA Medicare |
$13,142.96
|
| Rate for Payer: Humana ChoiceCare |
$14,457.26
|
| Rate for Payer: Humana Medicare Advantage |
$13,142.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,080.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,041.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,142.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,343.03
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,400.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,041.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,142.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,794.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,880.10
|
| Rate for Payer: United Healthcare Commercial |
$8,610.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,041.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,142.96
|
| Rate for Payer: Zelis Medicare |
$11,171.52
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,270.03
|
|
|
MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC
|
Facility
|
IP
|
$13,872.85
|
|
|
Service Code
|
MSDRG 726
|
| Min. Negotiated Rate |
$2,221.45 |
| Max. Negotiated Rate |
$13,872.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,221.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,029.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,221.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,183.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,160.50
|
| Rate for Payer: GEHA Medicare |
$8,160.50
|
| Rate for Payer: Humana ChoiceCare |
$8,976.55
|
| Rate for Payer: Humana Medicare Advantage |
$8,160.50
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,709.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,183.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,160.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,872.85
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,424.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,183.26
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,160.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,669.51
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,997.29
|
| Rate for Payer: United Healthcare Commercial |
$5,076.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,183.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,160.50
|
| Rate for Payer: Zelis Medicare |
$6,936.43
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,875.82
|
|
|
MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
|
IP
|
$108,595.46
|
|
|
Service Code
|
MSDRG 461
|
| Min. Negotiated Rate |
$28,899.50 |
| Max. Negotiated Rate |
$108,595.46 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$28,899.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$49,707.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$28,899.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$51,279.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$63,879.68
|
| Rate for Payer: GEHA Medicare |
$63,879.68
|
| Rate for Payer: Humana ChoiceCare |
$70,267.65
|
| Rate for Payer: Humana Medicare Advantage |
$63,879.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$107,317.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51,279.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$63,879.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$108,595.46
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$89,431.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51,279.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$63,879.68
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$91,347.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$62,602.09
|
| Rate for Payer: United Healthcare Commercial |
$41,852.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51,279.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63,879.68
|
| Rate for Payer: Zelis Medicare |
$54,297.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$40,195.39
|
|
|
MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$50,677.99
|
|
|
Service Code
|
MSDRG 462
|
| Min. Negotiated Rate |
$18,757.89 |
| Max. Negotiated Rate |
$50,677.99 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$21,002.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,196.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$21,002.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$37,337.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29,810.58
|
| Rate for Payer: GEHA Medicare |
$29,810.58
|
| Rate for Payer: Humana ChoiceCare |
$32,791.64
|
| Rate for Payer: Humana Medicare Advantage |
$29,810.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$50,081.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$37,337.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29,810.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$50,677.99
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$41,734.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$37,337.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29,810.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$42,629.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,214.37
|
| Rate for Payer: United Healthcare Commercial |
$19,531.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$37,337.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,810.58
|
| Rate for Payer: Zelis Medicare |
$25,338.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18,757.89
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$37,099.80
|
|
|
Service Code
|
MSDRG 409
|
| Min. Negotiated Rate |
$12,672.80 |
| Max. Negotiated Rate |
$37,099.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,672.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,981.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,672.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22,633.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,823.41
|
| Rate for Payer: GEHA Medicare |
$21,823.41
|
| Rate for Payer: Humana ChoiceCare |
$24,005.75
|
| Rate for Payer: Humana Medicare Advantage |
$21,823.41
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,663.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22,633.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,823.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,099.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,552.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22,633.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,823.41
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,207.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,386.94
|
| Rate for Payer: United Healthcare Commercial |
$14,298.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22,633.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,823.41
|
| Rate for Payer: Zelis Medicare |
$18,549.90
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,732.08
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$61,959.27
|
|
|
Service Code
|
MSDRG 408
|
| Min. Negotiated Rate |
$16,709.35 |
| Max. Negotiated Rate |
$61,959.27 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,709.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,360.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,709.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$29,759.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$36,446.63
|
| Rate for Payer: GEHA Medicare |
$36,446.63
|
| Rate for Payer: Humana ChoiceCare |
$40,091.29
|
| Rate for Payer: Humana Medicare Advantage |
$36,446.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$61,230.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$29,759.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$36,446.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$61,959.27
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$51,025.28
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$29,759.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$36,446.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$52,118.68
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$35,717.70
|
| Rate for Payer: United Healthcare Commercial |
$23,878.87
|
| Rate for Payer: United Healthcare Managed Medicaid |
$29,759.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,446.63
|
| Rate for Payer: Zelis Medicare |
$30,979.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,933.51
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$27,448.37
|
|
|
Service Code
|
MSDRG 410
|
| Min. Negotiated Rate |
$9,657.55 |
| Max. Negotiated Rate |
$27,448.37 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,657.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,563.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,657.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,310.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,146.10
|
| Rate for Payer: GEHA Medicare |
$16,146.10
|
| Rate for Payer: Humana ChoiceCare |
$17,760.71
|
| Rate for Payer: Humana Medicare Advantage |
$16,146.10
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,125.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,310.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,146.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,448.37
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,604.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,310.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,146.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,088.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,823.18
|
| Rate for Payer: United Healthcare Commercial |
$10,578.50
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,310.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,146.10
|
| Rate for Payer: Zelis Medicare |
$13,724.18
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,159.70
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$41,384.04
|
|
|
Service Code
|
MSDRG 478
|
| Min. Negotiated Rate |
$9,375.10 |
| Max. Negotiated Rate |
$41,384.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,375.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,942.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,375.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,811.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,343.55
|
| Rate for Payer: GEHA Medicare |
$24,343.55
|
| Rate for Payer: Humana ChoiceCare |
$26,777.90
|
| Rate for Payer: Humana Medicare Advantage |
$24,343.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$40,897.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,811.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,343.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$41,384.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$34,080.97
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,811.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,343.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$34,811.28
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,856.68
|
| Rate for Payer: United Healthcare Commercial |
$15,949.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,811.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,343.55
|
| Rate for Payer: Zelis Medicare |
$20,692.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,317.83
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$60,856.77
|
|
|
Service Code
|
MSDRG 477
|
| Min. Negotiated Rate |
$12,927.95 |
| Max. Negotiated Rate |
$60,856.77 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,927.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$27,855.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,927.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23,083.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35,798.10
|
| Rate for Payer: GEHA Medicare |
$35,798.10
|
| Rate for Payer: Humana ChoiceCare |
$39,377.91
|
| Rate for Payer: Humana Medicare Advantage |
$35,798.10
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$60,140.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23,083.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35,798.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$60,856.77
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$50,117.34
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23,083.88
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35,798.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$51,191.28
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$35,082.14
|
| Rate for Payer: United Healthcare Commercial |
$23,453.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23,083.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35,798.10
|
| Rate for Payer: Zelis Medicare |
$30,428.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,525.45
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$31,424.65
|
|
|
Service Code
|
MSDRG 479
|
| Min. Negotiated Rate |
$7,347.55 |
| Max. Negotiated Rate |
$31,424.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,347.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,383.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,347.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,232.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,485.09
|
| Rate for Payer: GEHA Medicare |
$18,485.09
|
| Rate for Payer: Humana ChoiceCare |
$20,333.60
|
| Rate for Payer: Humana Medicare Advantage |
$18,485.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,054.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,232.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,485.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,424.65
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,879.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,232.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,485.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,433.68
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,115.39
|
| Rate for Payer: United Healthcare Commercial |
$12,110.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,232.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,485.09
|
| Rate for Payer: Zelis Medicare |
$15,712.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,631.49
|
|
|
MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITH MCC
|
Facility
|
IP
|
$26,246.13
|
|
|
Service Code
|
MSDRG 553
|
| Min. Negotiated Rate |
$8,554.30 |
| Max. Negotiated Rate |
$26,246.13 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,719.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,578.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,719.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26,246.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,594.74
|
| Rate for Payer: GEHA Medicare |
$13,594.74
|
| Rate for Payer: Humana ChoiceCare |
$14,954.21
|
| Rate for Payer: Humana Medicare Advantage |
$13,594.74
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,839.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26,246.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,594.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,111.06
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,032.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26,246.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,594.74
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,440.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,322.85
|
| Rate for Payer: United Healthcare Commercial |
$8,906.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26,246.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,594.74
|
| Rate for Payer: Zelis Medicare |
$11,555.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,554.30
|
|
|
MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC
|
Facility
|
IP
|
$15,190.45
|
|
|
Service Code
|
MSDRG 554
|
| Min. Negotiated Rate |
$5,466.63 |
| Max. Negotiated Rate |
$15,190.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,850.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,760.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,850.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,590.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,935.56
|
| Rate for Payer: GEHA Medicare |
$8,935.56
|
| Rate for Payer: Humana ChoiceCare |
$9,829.12
|
| Rate for Payer: Humana Medicare Advantage |
$8,935.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,011.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,590.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,935.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,190.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,509.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,590.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,935.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,777.85
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,756.85
|
| Rate for Payer: United Healthcare Commercial |
$5,691.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,590.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,935.56
|
| Rate for Payer: Zelis Medicare |
$7,595.23
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,466.63
|
|
|
MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$36,230.96
|
|
|
Service Code
|
MSDRG 584
|
| Min. Negotiated Rate |
$5,234.25 |
| Max. Negotiated Rate |
$36,230.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,234.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,583.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,234.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,501.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,312.33
|
| Rate for Payer: GEHA Medicare |
$21,312.33
|
| Rate for Payer: Humana ChoiceCare |
$23,443.56
|
| Rate for Payer: Humana Medicare Advantage |
$21,312.33
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$35,804.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,501.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,312.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$36,230.96
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,837.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,501.88
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,312.33
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$30,476.63
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,886.08
|
| Rate for Payer: United Healthcare Commercial |
$13,963.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,501.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,312.33
|
| Rate for Payer: Zelis Medicare |
$18,115.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,410.47
|
|
|
MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$35,128.48
|
|
|
Service Code
|
MSDRG 585
|
| Min. Negotiated Rate |
$3,876.25 |
| Max. Negotiated Rate |
$35,128.48 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,876.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,079.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,876.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,104.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,663.81
|
| Rate for Payer: GEHA Medicare |
$20,663.81
|
| Rate for Payer: Humana ChoiceCare |
$22,730.19
|
| Rate for Payer: Humana Medicare Advantage |
$20,663.81
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,715.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,104.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,663.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,128.48
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,929.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,104.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,663.81
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,549.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,250.53
|
| Rate for Payer: United Healthcare Commercial |
$13,538.38
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,104.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,663.81
|
| Rate for Payer: Zelis Medicare |
$17,564.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,002.41
|
|
