|
MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$68,814.71
|
|
|
Service Code
|
MSDRG 034
|
| Min. Negotiated Rate |
$25,470.99 |
| Max. Negotiated Rate |
$68,814.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$25,965.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$31,498.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$25,965.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$46,099.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$40,479.24
|
| Rate for Payer: GEHA Medicare |
$40,479.24
|
| Rate for Payer: Humana ChoiceCare |
$44,527.16
|
| Rate for Payer: Humana Medicare Advantage |
$40,479.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$68,005.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$46,099.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$40,479.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$68,814.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$56,670.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$46,099.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$40,479.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$57,885.31
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$39,669.66
|
| Rate for Payer: United Healthcare Commercial |
$26,520.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$46,099.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40,479.24
|
| Rate for Payer: Zelis Medicare |
$34,407.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$25,470.99
|
|
|
MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$32,438.67
|
|
|
Service Code
|
MSDRG 036
|
| Min. Negotiated Rate |
$7,661.50 |
| Max. Negotiated Rate |
$32,438.67 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,661.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,848.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,661.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,786.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,081.57
|
| Rate for Payer: GEHA Medicare |
$19,081.57
|
| Rate for Payer: Humana ChoiceCare |
$20,989.73
|
| Rate for Payer: Humana Medicare Advantage |
$19,081.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,057.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,786.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,081.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,438.67
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,714.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,786.80
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,081.57
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,286.65
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,699.94
|
| Rate for Payer: United Healthcare Commercial |
$12,501.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,786.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,081.57
|
| Rate for Payer: Zelis Medicare |
$16,219.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,006.81
|
|
|
MS-DRG 42.00: CELLULITIS WITH MCC
|
Facility
|
IP
|
$25,999.07
|
|
|
Service Code
|
MSDRG 602
|
| Min. Negotiated Rate |
$6,283.90 |
| Max. Negotiated Rate |
$25,999.07 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,283.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,900.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,283.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,354.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,293.57
|
| Rate for Payer: GEHA Medicare |
$15,293.57
|
| Rate for Payer: Humana ChoiceCare |
$16,822.93
|
| Rate for Payer: Humana Medicare Advantage |
$15,293.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,693.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,354.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,293.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,999.07
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,411.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,354.87
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,293.57
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,869.81
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,987.70
|
| Rate for Payer: United Healthcare Commercial |
$10,019.94
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,354.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,293.57
|
| Rate for Payer: Zelis Medicare |
$12,999.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,623.26
|
|
|
MS-DRG 42.00: CELLULITIS WITHOUT MCC
|
Facility
|
IP
|
$15,865.33
|
|
|
Service Code
|
MSDRG 603
|
| Min. Negotiated Rate |
$3,016.65 |
| Max. Negotiated Rate |
$15,865.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,016.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,134.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,016.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,587.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,332.55
|
| Rate for Payer: GEHA Medicare |
$9,332.55
|
| Rate for Payer: Humana ChoiceCare |
$10,265.81
|
| Rate for Payer: Humana Medicare Advantage |
$9,332.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,678.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,587.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,332.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,865.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,065.57
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,587.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,332.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,345.55
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,145.90
|
| Rate for Payer: United Healthcare Commercial |
$6,007.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,587.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,332.55
|
| Rate for Payer: Zelis Medicare |
$7,932.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,769.24
|
|
|
MS-DRG 42.00: CERVICAL SPINAL FUSION WITH CC
|
Facility
|
IP
|
$51,269.04
|
|
|
Service Code
|
MSDRG 472
|
| Min. Negotiated Rate |
$9,868.60 |
| Max. Negotiated Rate |
$51,269.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,868.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,467.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,868.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,683.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$30,158.26
|
| Rate for Payer: GEHA Medicare |
$30,158.26
|
| Rate for Payer: Humana ChoiceCare |
$33,174.09
|
| Rate for Payer: Humana Medicare Advantage |
$30,158.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$50,665.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,683.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$30,158.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$51,269.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$42,221.56
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,683.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$30,158.26
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$43,126.31
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,555.09
|
| Rate for Payer: United Healthcare Commercial |
$19,758.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,683.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,158.26
|
| Rate for Payer: Zelis Medicare |
$25,634.52
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18,976.66
|
|
|
MS-DRG 42.00: CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$85,955.13
|
|
|
Service Code
|
MSDRG 471
|
| Min. Negotiated Rate |
$11,541.60 |
| Max. Negotiated Rate |
$85,955.13 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,541.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$39,344.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,541.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,636.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$50,561.84
|
| Rate for Payer: GEHA Medicare |
$50,561.84
|
| Rate for Payer: Humana ChoiceCare |
$55,618.02
|
| Rate for Payer: Humana Medicare Advantage |
$50,561.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$84,943.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,636.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$50,561.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$85,955.13
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$70,786.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,636.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$50,561.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$72,303.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$49,550.60
|
| Rate for Payer: United Healthcare Commercial |
$33,126.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,636.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50,561.84
|
| Rate for Payer: Zelis Medicare |
$42,977.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$31,815.31
|
|
|
MS-DRG 42.00: CERVICAL SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$41,893.66
|
|
|
Service Code
|
MSDRG 473
|
| Min. Negotiated Rate |
$7,724.15 |
| Max. Negotiated Rate |
$41,893.66 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,724.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,175.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,724.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,897.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,643.33
|
| Rate for Payer: GEHA Medicare |
$24,643.33
|
| Rate for Payer: Humana ChoiceCare |
$27,107.66
|
| Rate for Payer: Humana Medicare Advantage |
$24,643.33
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$41,400.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,897.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,643.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$41,893.66
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$34,500.66
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,897.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,643.33
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35,239.96
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,150.46
|
| Rate for Payer: United Healthcare Commercial |
$16,145.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,897.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,643.33
|
| Rate for Payer: Zelis Medicare |
$20,946.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,506.47
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH CC
|
Facility
|
IP
|
$18,789.67
|
|
|
Service Code
|
MSDRG 787
|
| Min. Negotiated Rate |
$4,049.85 |
| Max. Negotiated Rate |
$18,789.67 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,049.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,600.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,049.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,411.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,052.75
|
| Rate for Payer: GEHA Medicare |
$11,052.75
|
| Rate for Payer: Humana ChoiceCare |
$12,158.02
|
| Rate for Payer: Humana Medicare Advantage |
$11,052.75
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,568.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,411.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,052.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,789.67
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,473.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,411.01
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,052.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,805.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,831.69
|
| Rate for Payer: United Healthcare Commercial |
$7,241.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,411.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,052.75
|
| Rate for Payer: Zelis Medicare |
$9,394.84
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,954.79
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC
|
Facility
|
IP
|
$28,595.12
|
|
|
Service Code
|
MSDRG 786
|
| Min. Negotiated Rate |
$5,593.00 |
| Max. Negotiated Rate |
$28,595.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,593.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,088.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,593.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,135.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,820.66
|
| Rate for Payer: GEHA Medicare |
$16,820.66
|
| Rate for Payer: Humana ChoiceCare |
$18,502.73
|
| Rate for Payer: Humana Medicare Advantage |
$16,820.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,258.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,135.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,820.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,595.12
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,548.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,135.20
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,820.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,053.54
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,484.25
|
| Rate for Payer: United Healthcare Commercial |
$11,020.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,135.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,820.66
|
| Rate for Payer: Zelis Medicare |
$14,297.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,584.15
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$16,214.41
|
|
|
Service Code
|
MSDRG 788
|
| Min. Negotiated Rate |
$3,657.85 |
| Max. Negotiated Rate |
$16,214.41 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,657.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,328.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,657.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,719.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,537.89
|
| Rate for Payer: GEHA Medicare |
$9,537.89
|
| Rate for Payer: Humana ChoiceCare |
$10,491.68
|
| Rate for Payer: Humana Medicare Advantage |
$9,537.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,023.66
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,719.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,537.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,214.41
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,353.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,719.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,537.89
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,639.18
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,347.13
|
| Rate for Payer: United Healthcare Commercial |
$6,170.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,719.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,537.89
|
| Rate for Payer: Zelis Medicare |
$8,107.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,925.78
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH CC
|
Facility
|
IP
|
$19,164.87
|
|
|
Service Code
|
MSDRG 784
|
| Min. Negotiated Rate |
$3,898.30 |
| Max. Negotiated Rate |
$19,164.87 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,898.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,772.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,898.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,143.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,273.45
|
| Rate for Payer: GEHA Medicare |
$11,273.45
|
| Rate for Payer: Humana ChoiceCare |
$12,400.80
|
| Rate for Payer: Humana Medicare Advantage |
$11,273.45
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,939.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,143.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,273.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,164.87
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,782.83
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,143.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,273.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,121.03
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,047.98
|
| Rate for Payer: United Healthcare Commercial |
$7,386.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,143.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,273.45
|
| Rate for Payer: Zelis Medicare |
$9,582.43
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,093.65
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH MCC
|
Facility
|
IP
|
$32,597.92
|
|
|
Service Code
|
MSDRG 783
|
| Min. Negotiated Rate |
$5,862.85 |
| Max. Negotiated Rate |
$32,597.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,862.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,921.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,862.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,611.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,175.25
|
| Rate for Payer: GEHA Medicare |
$19,175.25
|
| Rate for Payer: Humana ChoiceCare |
$21,092.78
|
| Rate for Payer: Humana Medicare Advantage |
$19,175.25
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,214.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,611.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,175.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,597.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,845.35
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,611.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,175.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,420.61
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,791.74
|
| Rate for Payer: United Healthcare Commercial |
$12,563.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,611.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,175.25
|
| Rate for Payer: Zelis Medicare |
$16,298.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,065.75
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$15,758.71
|
|
|
Service Code
|
MSDRG 785
|
| Min. Negotiated Rate |
$3,530.10 |
| Max. Negotiated Rate |
$15,758.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,530.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,075.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,530.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,493.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,269.83
|
| Rate for Payer: GEHA Medicare |
$9,269.83
|
| Rate for Payer: Humana ChoiceCare |
$10,196.81
|
| Rate for Payer: Humana Medicare Advantage |
$9,269.83
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,573.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,493.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,269.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,758.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,977.76
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,493.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,269.83
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,255.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,084.43
|
| Rate for Payer: United Healthcare Commercial |
$5,957.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,493.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,269.83
|
| Rate for Payer: Zelis Medicare |
$7,879.36
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,721.43
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC
|
Facility
|
IP
|
$88,607.76
|
|
|
Service Code
|
MSDRG 837
|
| Min. Negotiated Rate |
$11,365.55 |
| Max. Negotiated Rate |
$88,607.76 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,365.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40,558.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,365.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,325.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$52,122.21
|
| Rate for Payer: GEHA Medicare |
$52,122.21
|
| Rate for Payer: Humana ChoiceCare |
$57,334.43
|
| Rate for Payer: Humana Medicare Advantage |
$52,122.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$87,565.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,325.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$52,122.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$88,607.76
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$72,971.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,325.71
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$52,122.21
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$74,534.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$51,079.77
|
| Rate for Payer: United Healthcare Commercial |
$34,149.10
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,325.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$52,122.21
|
| Rate for Payer: Zelis Medicare |
$44,303.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$32,797.16
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT
|
Facility
|
IP
|
$35,891.17
|
|
|
Service Code
|
MSDRG 838
|
| Min. Negotiated Rate |
$7,609.00 |
| Max. Negotiated Rate |
$35,891.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,609.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,428.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,609.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,694.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,112.45
|
| Rate for Payer: GEHA Medicare |
$21,112.45
|
| Rate for Payer: Humana ChoiceCare |
$23,223.69
|
| Rate for Payer: Humana Medicare Advantage |
$21,112.45
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$35,468.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,694.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,112.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,891.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,557.43
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,694.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,112.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$30,190.80
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,690.20
|
| Rate for Payer: United Healthcare Commercial |
$13,832.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,694.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,112.45
|
| Rate for Payer: Zelis Medicare |
$17,945.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,284.71
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$24,250.70
|
|
|
Service Code
|
MSDRG 839
|
| Min. Negotiated Rate |
$6,128.85 |
| Max. Negotiated Rate |
$24,250.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,128.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,100.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,128.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,081.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,265.12
|
| Rate for Payer: GEHA Medicare |
$14,265.12
|
| Rate for Payer: Humana ChoiceCare |
$15,691.63
|
| Rate for Payer: Humana Medicare Advantage |
$14,265.12
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,965.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,081.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,265.12
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,250.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,971.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,081.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,265.12
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,399.12
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,979.82
|
| Rate for Payer: United Healthcare Commercial |
$9,346.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,081.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,265.12
|
| Rate for Payer: Zelis Medicare |
$12,125.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,976.12
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC
|
Facility
|
IP
|
$22,486.38
|
|
|
Service Code
|
MSDRG 847
|
| Min. Negotiated Rate |
$4,954.95 |
| Max. Negotiated Rate |
$22,486.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,954.95
|
| 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 |
$4,954.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,008.82
|
| 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 |
$9,008.82
|
| 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 |
$9,008.82
|
| 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 |
$9,008.82
|
| 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: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$45,192.22
|
|
|
Service Code
|
MSDRG 846
|
| Min. Negotiated Rate |
$7,068.25 |
| Max. Negotiated Rate |
$45,192.22 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,068.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,685.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,068.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,739.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,583.66
|
| Rate for Payer: GEHA Medicare |
$26,583.66
|
| Rate for Payer: Humana ChoiceCare |
$29,242.03
|
| Rate for Payer: Humana Medicare Advantage |
$26,583.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$44,660.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,739.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,583.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$45,192.22
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$37,217.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,739.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,583.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$38,014.63
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$26,051.99
|
| Rate for Payer: United Healthcare Commercial |
$17,416.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,739.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,583.66
|
| Rate for Payer: Zelis Medicare |
$22,596.11
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,727.39
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$14,961.12
|
|
|
Service Code
|
MSDRG 848
|
| Min. Negotiated Rate |
$4,183.20 |
| Max. Negotiated Rate |
$14,961.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,183.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,633.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,183.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,646.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,800.66
|
| Rate for Payer: GEHA Medicare |
$8,800.66
|
| Rate for Payer: Humana ChoiceCare |
$9,680.73
|
| Rate for Payer: Humana Medicare Advantage |
$8,800.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,785.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,646.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,800.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,961.12
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,320.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,646.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,800.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,584.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,624.65
|
| Rate for Payer: United Healthcare Commercial |
$5,584.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,646.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,800.66
|
| Rate for Payer: Zelis Medicare |
$7,480.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,363.80
|
|
|
MS-DRG 42.00: CHEST PAIN
|
Facility
|
IP
|
$13,420.00
|
|
|
Service Code
|
MSDRG 313
|
| Min. Negotiated Rate |
$2,740.85 |
| Max. Negotiated Rate |
$13,420.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,740.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,778.54
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,740.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,100.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,894.12
|
| Rate for Payer: GEHA Medicare |
$7,894.12
|
| Rate for Payer: Humana ChoiceCare |
$8,683.53
|
| Rate for Payer: Humana Medicare Advantage |
$7,894.12
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,262.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,100.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,894.12
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,420.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,051.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,100.18
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,894.12
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,288.59
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,736.24
|
| Rate for Payer: United Healthcare Commercial |
$4,865.39
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,100.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,894.12
|
| Rate for Payer: Zelis Medicare |
$6,710.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,672.77
|
|
|
MS-DRG 42.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$667,368.30
|
|
|
Service Code
|
MSDRG 018
|
| Min. Negotiated Rate |
$130,651.50 |
| Max. Negotiated Rate |
$667,368.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$130,651.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$305,473.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$130,651.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$230,905.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$392,569.59
|
| Rate for Payer: GEHA Medicare |
$392,569.59
|
| Rate for Payer: Humana ChoiceCare |
$431,826.55
|
| Rate for Payer: Humana Medicare Advantage |
$392,569.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$659,516.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$230,905.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$392,569.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$667,368.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$549,597.43
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$230,905.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$392,569.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$561,374.51
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$384,718.20
|
| Rate for Payer: United Healthcare Commercial |
$257,201.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$230,905.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$392,569.59
|
| Rate for Payer: Zelis Medicare |
$333,684.15
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$247,018.84
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$35,004.61
|
|
|
Service Code
|
MSDRG 415
|
| Min. Negotiated Rate |
$8,443.05 |
| Max. Negotiated Rate |
$35,004.61 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,443.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,022.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,443.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,166.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,590.95
|
| Rate for Payer: GEHA Medicare |
$20,590.95
|
| Rate for Payer: Humana ChoiceCare |
$22,650.04
|
| Rate for Payer: Humana Medicare Advantage |
$20,590.95
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,592.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,166.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,590.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,004.61
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,827.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,166.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,590.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,445.06
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,179.13
|
| Rate for Payer: United Healthcare Commercial |
$13,490.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,166.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,590.95
|
| Rate for Payer: Zelis Medicare |
$17,502.31
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,956.56
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$62,003.49
|
|
|
Service Code
|
MSDRG 414
|
| Min. Negotiated Rate |
$11,433.45 |
| Max. Negotiated Rate |
$62,003.49 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,433.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,380.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,433.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,445.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$36,472.64
|
| Rate for Payer: GEHA Medicare |
$36,472.64
|
| Rate for Payer: Humana ChoiceCare |
$40,119.90
|
| Rate for Payer: Humana Medicare Advantage |
$36,472.64
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$61,274.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,445.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$36,472.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$62,003.49
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$51,061.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,445.58
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$36,472.64
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$52,155.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$35,743.19
|
| Rate for Payer: United Healthcare Commercial |
$23,895.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,445.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,472.64
|
| Rate for Payer: Zelis Medicare |
$31,001.74
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,949.89
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$24,247.15
|
|
|
Service Code
|
MSDRG 416
|
| Min. Negotiated Rate |
$6,254.15 |
| Max. Negotiated Rate |
$24,247.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,254.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,098.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,254.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,302.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,263.03
|
| Rate for Payer: GEHA Medicare |
$14,263.03
|
| Rate for Payer: Humana ChoiceCare |
$15,689.33
|
| Rate for Payer: Humana Medicare Advantage |
$14,263.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,961.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,302.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,263.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,247.15
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,968.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,302.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,263.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,396.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,977.77
|
| Rate for Payer: United Healthcare Commercial |
$9,344.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,302.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,263.03
|
| Rate for Payer: Zelis Medicare |
$12,123.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,974.81
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH CC
|
Facility
|
IP
|
$37,720.94
|
|
|
Service Code
|
MSDRG 412
|
| Min. Negotiated Rate |
$7,969.15 |
| Max. Negotiated Rate |
$37,720.94 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,969.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,265.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,969.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,329.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,188.79
|
| Rate for Payer: GEHA Medicare |
$22,188.79
|
| Rate for Payer: Humana ChoiceCare |
$24,407.67
|
| Rate for Payer: Humana Medicare Advantage |
$22,188.79
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,277.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,329.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,188.79
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,720.94
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,064.31
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,329.91
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,188.79
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,729.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,745.01
|
| Rate for Payer: United Healthcare Commercial |
$14,537.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,329.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,188.79
|
| Rate for Payer: Zelis Medicare |
$18,860.47
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,961.98
|
|
