|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH MCC
|
Facility
|
IP
|
$48,423.51
|
|
|
Service Code
|
MSDRG 411
|
| Min. Negotiated Rate |
$8,115.10 |
| Max. Negotiated Rate |
$48,423.51 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,115.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$22,164.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,115.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,587.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$28,484.42
|
| Rate for Payer: GEHA Medicare |
$28,484.42
|
| Rate for Payer: Humana ChoiceCare |
$31,332.86
|
| Rate for Payer: Humana Medicare Advantage |
$28,484.42
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$47,853.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,587.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$28,484.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$48,423.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$39,878.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,587.56
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$28,484.42
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$40,732.72
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27,914.73
|
| Rate for Payer: United Healthcare Commercial |
$18,662.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,587.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28,484.42
|
| Rate for Payer: Zelis Medicare |
$24,211.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,923.42
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$29,419.74
|
|
|
Service Code
|
MSDRG 413
|
| Min. Negotiated Rate |
$7,592.55 |
| Max. Negotiated Rate |
$29,419.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,592.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,466.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,592.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,665.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,305.73
|
| Rate for Payer: GEHA Medicare |
$17,305.73
|
| Rate for Payer: Humana ChoiceCare |
$19,036.30
|
| Rate for Payer: Humana Medicare Advantage |
$17,305.73
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,073.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,665.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,305.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,419.74
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,228.02
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,665.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,305.73
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,747.19
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,959.62
|
| Rate for Payer: United Healthcare Commercial |
$11,338.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,665.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,305.73
|
| Rate for Payer: Zelis Medicare |
$14,709.87
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,889.38
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC
|
Facility
|
IP
|
$15,548.30
|
|
|
Service Code
|
MSDRG 191
|
| Min. Negotiated Rate |
$4,645.90 |
| Max. Negotiated Rate |
$15,548.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,645.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,958.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,645.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,463.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,146.06
|
| Rate for Payer: GEHA Medicare |
$9,146.06
|
| Rate for Payer: Humana ChoiceCare |
$10,060.67
|
| Rate for Payer: Humana Medicare Advantage |
$9,146.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,365.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,463.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,146.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,548.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,804.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,463.24
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,146.06
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,078.87
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,963.14
|
| Rate for Payer: United Healthcare Commercial |
$5,859.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,463.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,146.06
|
| Rate for Payer: Zelis Medicare |
$7,774.15
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,627.10
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC
|
Facility
|
IP
|
$19,872.66
|
|
|
Service Code
|
MSDRG 190
|
| Min. Negotiated Rate |
$6,259.40 |
| Max. Negotiated Rate |
$19,872.66 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,259.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,096.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,259.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,311.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,689.80
|
| Rate for Payer: GEHA Medicare |
$11,689.80
|
| Rate for Payer: Humana ChoiceCare |
$12,858.78
|
| Rate for Payer: Humana Medicare Advantage |
$11,689.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,638.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,311.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,689.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,872.66
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,365.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,311.62
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,689.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,716.41
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,456.00
|
| Rate for Payer: United Healthcare Commercial |
$7,658.86
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,311.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,689.80
|
| Rate for Payer: Zelis Medicare |
$9,936.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,355.65
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$12,452.99
|
|
|
Service Code
|
MSDRG 192
|
| Min. Negotiated Rate |
$3,744.65 |
| Max. Negotiated Rate |
$12,452.99 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,744.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,242.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,744.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,872.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,325.29
|
| Rate for Payer: GEHA Medicare |
$7,325.29
|
| Rate for Payer: Humana ChoiceCare |
$8,057.82
|
| Rate for Payer: Humana Medicare Advantage |
$7,325.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,306.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,872.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,325.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,452.99
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,255.41
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,872.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,325.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,475.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,178.78
|
| Rate for Payer: United Healthcare Commercial |
$4,413.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,872.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,325.29
|
| Rate for Payer: Zelis Medicare |
$6,226.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,239.16
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$39,166.71
|
|
|
Service Code
|
MSDRG 286
|
| Min. Negotiated Rate |
$7,089.25 |
| Max. Negotiated Rate |
$39,166.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,089.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,927.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,089.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,776.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,039.24
|
| Rate for Payer: GEHA Medicare |
$23,039.24
|
| Rate for Payer: Humana ChoiceCare |
$25,343.16
|
| Rate for Payer: Humana Medicare Advantage |
$23,039.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$38,705.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,776.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,039.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39,166.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,254.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,776.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,039.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$32,946.11
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,578.46
|
| Rate for Payer: United Healthcare Commercial |
$15,094.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,776.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,039.24
|
| Rate for Payer: Zelis Medicare |
$19,583.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,497.11
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$19,283.44
|
|
|
Service Code
|
MSDRG 287
|
| Min. Negotiated Rate |
$6,232.10 |
| Max. Negotiated Rate |
$19,283.44 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,232.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,826.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,232.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,263.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,343.20
|
| Rate for Payer: GEHA Medicare |
$11,343.20
|
| Rate for Payer: Humana ChoiceCare |
$12,477.52
|
| Rate for Payer: Humana Medicare Advantage |
$11,343.20
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,056.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,263.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,343.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,283.44
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,880.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,263.43
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,343.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,220.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,116.34
|
| Rate for Payer: United Healthcare Commercial |
$7,431.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,263.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,343.20
|
| Rate for Payer: Zelis Medicare |
$9,641.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,137.53
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$18,931.23
|
|
|
Service Code
|
MSDRG 433
|
| Min. Negotiated Rate |
$4,682.65 |
| Max. Negotiated Rate |
$18,931.23 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,682.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,665.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,682.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,528.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,136.02
|
| Rate for Payer: GEHA Medicare |
$11,136.02
|
| Rate for Payer: Humana ChoiceCare |
$12,249.62
|
| Rate for Payer: Humana Medicare Advantage |
$11,136.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,708.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,528.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,136.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,931.23
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,590.43
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,528.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,136.02
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,924.51
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,913.30
|
| Rate for Payer: United Healthcare Commercial |
$7,296.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,528.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,136.02
|
| Rate for Payer: Zelis Medicare |
$9,465.62
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,007.19
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$34,668.37
|
|
|
Service Code
|
MSDRG 432
|
| Min. Negotiated Rate |
$8,677.90 |
| Max. Negotiated Rate |
$34,668.37 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,677.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,868.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,677.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,581.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,393.16
|
| Rate for Payer: GEHA Medicare |
$20,393.16
|
| Rate for Payer: Humana ChoiceCare |
$22,432.48
|
| Rate for Payer: Humana Medicare Advantage |
$20,393.16
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,260.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,581.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,393.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,668.37
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,550.42
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,581.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,393.16
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,162.22
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,985.30
|
| Rate for Payer: United Healthcare Commercial |
$13,361.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,581.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,393.16
|
| Rate for Payer: Zelis Medicare |
$17,334.19
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,832.10
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,173.15
|
|
|
Service Code
|
MSDRG 434
|
| Min. Negotiated Rate |
$2,736.30 |
| Max. Negotiated Rate |
$13,173.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,736.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,641.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,736.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,092.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,748.91
|
| Rate for Payer: GEHA Medicare |
$7,748.91
|
| Rate for Payer: Humana ChoiceCare |
$8,523.80
|
| Rate for Payer: Humana Medicare Advantage |
$7,748.91
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,018.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,092.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,748.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,173.15
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,848.47
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,092.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,748.91
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,080.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,593.93
|
| Rate for Payer: United Healthcare Commercial |
$4,750.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,092.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,748.91
|
| Rate for Payer: Zelis Medicare |
$6,586.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,562.07
|
|
|
MS-DRG 42.00: COAGULATION DISORDERS
|
Facility
|
IP
|
$27,393.51
|
|
|
Service Code
|
MSDRG 813
|
| Min. Negotiated Rate |
$3,430.70 |
| Max. Negotiated Rate |
$27,393.51 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,430.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,538.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,430.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,318.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,113.83
|
| Rate for Payer: GEHA Medicare |
$16,113.83
|
| Rate for Payer: Humana ChoiceCare |
$17,725.21
|
| Rate for Payer: Humana Medicare Advantage |
$16,113.83
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,071.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,318.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,113.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,393.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,559.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,318.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,113.83
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,042.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,791.55
|
| Rate for Payer: United Healthcare Commercial |
$10,557.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,318.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,113.83
|
| Rate for Payer: Zelis Medicare |
$13,696.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,139.40
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$147,595.85
|
|
|
Service Code
|
MSDRG 429
|
| Min. Negotiated Rate |
$30,220.40 |
| Max. Negotiated Rate |
$147,595.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$30,220.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$67,558.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$30,220.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$53,610.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$86,821.09
|
| Rate for Payer: GEHA Medicare |
$86,821.09
|
| Rate for Payer: Humana ChoiceCare |
$95,503.20
|
| Rate for Payer: Humana Medicare Advantage |
$86,821.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$145,859.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$53,610.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$86,821.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$147,595.85
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$121,549.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$53,610.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$86,821.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$124,154.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$85,084.67
|
| Rate for Payer: United Healthcare Commercial |
$56,882.89
|
| Rate for Payer: United Healthcare Managed Medicaid |
$53,610.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$86,821.09
|
| Rate for Payer: Zelis Medicare |
$73,797.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$54,630.93
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC
|
Facility
|
IP
|
$96,806.36
|
|
|
Service Code
|
MSDRG 430
|
| Min. Negotiated Rate |
$19,729.50 |
| Max. Negotiated Rate |
$96,806.36 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$19,729.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$44,311.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$19,729.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$35,090.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56,944.92
|
| Rate for Payer: GEHA Medicare |
$56,944.92
|
| Rate for Payer: Humana ChoiceCare |
$62,639.41
|
| Rate for Payer: Humana Medicare Advantage |
$56,944.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$95,667.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$35,090.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56,944.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$96,806.36
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$79,722.89
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$35,090.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56,944.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$81,431.24
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55,806.02
|
| Rate for Payer: United Healthcare Commercial |
$37,308.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$35,090.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56,944.92
|
| Rate for Payer: Zelis Medicare |
$48,403.18
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35,831.78
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC
|
Facility
|
IP
|
$19,272.78
|
|
|
Service Code
|
MSDRG 381
|
| Min. Negotiated Rate |
$4,372.20 |
| Max. Negotiated Rate |
$19,272.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,372.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,821.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,372.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,980.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,336.93
|
| Rate for Payer: GEHA Medicare |
$11,336.93
|
| Rate for Payer: Humana ChoiceCare |
$12,470.62
|
| Rate for Payer: Humana Medicare Advantage |
$11,336.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,046.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,980.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,336.93
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,272.78
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,871.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,980.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,336.93
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,211.81
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,110.19
|
| Rate for Payer: United Healthcare Commercial |
$7,427.66
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,980.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,336.93
|
| Rate for Payer: Zelis Medicare |
$9,636.39
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,133.60
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$34,052.53
|
|
|
Service Code
|
MSDRG 380
|
| Min. Negotiated Rate |
$7,417.20 |
| Max. Negotiated Rate |
$34,052.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,417.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,586.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,417.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,355.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,030.90
|
| Rate for Payer: GEHA Medicare |
$20,030.90
|
| Rate for Payer: Humana ChoiceCare |
$22,033.99
|
| Rate for Payer: Humana Medicare Advantage |
$20,030.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$33,651.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,355.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,030.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,052.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,043.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,355.53
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,030.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,644.19
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,630.28
|
| Rate for Payer: United Healthcare Commercial |
$13,123.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,355.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,030.90
|
| Rate for Payer: Zelis Medicare |
$17,026.26
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,604.17
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC
|
Facility
|
IP
|
$13,944.40
|
|
|
Service Code
|
MSDRG 382
|
| Min. Negotiated Rate |
$3,142.65 |
| Max. Negotiated Rate |
$13,944.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,142.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,069.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,142.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,809.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,202.59
|
| Rate for Payer: GEHA Medicare |
$8,202.59
|
| Rate for Payer: Humana ChoiceCare |
$9,022.85
|
| Rate for Payer: Humana Medicare Advantage |
$8,202.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,780.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,809.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,202.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,944.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,483.63
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,809.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,202.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,729.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,038.54
|
| Rate for Payer: United Healthcare Commercial |
$5,110.23
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,809.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,202.59
|
| Rate for Payer: Zelis Medicare |
$6,972.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,907.91
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC
|
Facility
|
IP
|
$17,977.43
|
|
|
Service Code
|
MSDRG 920
|
| Min. Negotiated Rate |
$3,109.05 |
| Max. Negotiated Rate |
$17,977.43 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,109.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,228.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,109.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,750.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,574.96
|
| Rate for Payer: GEHA Medicare |
$10,574.96
|
| Rate for Payer: Humana ChoiceCare |
$11,632.46
|
| Rate for Payer: Humana Medicare Advantage |
$10,574.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,765.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,750.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,574.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,977.43
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,804.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,750.18
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,574.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,122.19
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,363.46
|
| Rate for Payer: United Healthcare Commercial |
$6,928.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,750.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,574.96
|
| Rate for Payer: Zelis Medicare |
$8,988.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,654.15
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC
|
Facility
|
IP
|
$32,270.56
|
|
|
Service Code
|
MSDRG 919
|
| Min. Negotiated Rate |
$4,187.40 |
| Max. Negotiated Rate |
$32,270.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,187.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,771.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,187.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,653.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,982.68
|
| Rate for Payer: GEHA Medicare |
$18,982.68
|
| Rate for Payer: Humana ChoiceCare |
$20,880.95
|
| Rate for Payer: Humana Medicare Advantage |
$18,982.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,890.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,653.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,982.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,270.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,575.75
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,653.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,982.68
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,145.23
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,603.03
|
| Rate for Payer: United Healthcare Commercial |
$12,436.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,653.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,982.68
|
| Rate for Payer: Zelis Medicare |
$16,135.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,944.58
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$13,044.63
|
|
|
Service Code
|
MSDRG 921
|
| Min. Negotiated Rate |
$2,487.10 |
| Max. Negotiated Rate |
$13,044.63 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,487.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,570.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,487.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,652.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,673.31
|
| Rate for Payer: GEHA Medicare |
$7,673.31
|
| Rate for Payer: Humana ChoiceCare |
$8,440.64
|
| Rate for Payer: Humana Medicare Advantage |
$7,673.31
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,891.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,652.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,673.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,044.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,742.63
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,652.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,673.31
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,972.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,519.84
|
| Rate for Payer: United Healthcare Commercial |
$4,690.11
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,652.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,673.31
|
| Rate for Payer: Zelis Medicare |
$6,522.31
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,504.44
|
|
|
MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES
|
Facility
|
IP
|
$192,779.22
|
|
|
Service Code
|
MSDRG 212
|
| Min. Negotiated Rate |
$40,439.35 |
| Max. Negotiated Rate |
$192,779.22 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$40,439.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$88,240.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$40,439.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$71,650.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$113,399.54
|
| Rate for Payer: GEHA Medicare |
$113,399.54
|
| Rate for Payer: Humana ChoiceCare |
$124,739.49
|
| Rate for Payer: Humana Medicare Advantage |
$113,399.54
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$190,511.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71,650.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$113,399.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$192,779.22
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$158,759.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71,650.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$113,399.54
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$162,161.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$111,131.55
|
| Rate for Payer: United Healthcare Commercial |
$74,296.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71,650.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$113,399.54
|
| Rate for Payer: Zelis Medicare |
$96,389.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$71,355.04
|
|
|
MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION
|
Facility
|
IP
|
$109,474.97
|
|
|
Service Code
|
MSDRG 317
|
| Min. Negotiated Rate |
$38,181.50 |
| Max. Negotiated Rate |
$109,474.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$38,181.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$50,109.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$38,181.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$67,664.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$64,397.04
|
| Rate for Payer: GEHA Medicare |
$64,397.04
|
| Rate for Payer: Humana ChoiceCare |
$70,836.74
|
| Rate for Payer: Humana Medicare Advantage |
$64,397.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$108,187.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$67,664.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$64,397.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$109,474.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$90,155.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$67,664.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$64,397.04
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$92,087.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$63,109.10
|
| Rate for Payer: United Healthcare Commercial |
$42,191.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$67,664.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$64,397.04
|
| Rate for Payer: Zelis Medicare |
$54,737.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$40,520.92
|
|
|
MS-DRG 42.00: CONCUSSION WITH CC
|
Facility
|
IP
|
$18,971.97
|
|
|
Service Code
|
MSDRG 089
|
| Min. Negotiated Rate |
$3,691.80 |
| Max. Negotiated Rate |
$18,971.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,691.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,684.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,691.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,778.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,159.98
|
| Rate for Payer: GEHA Medicare |
$11,159.98
|
| Rate for Payer: Humana ChoiceCare |
$12,275.98
|
| Rate for Payer: Humana Medicare Advantage |
$11,159.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,748.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,778.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,159.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,971.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,623.97
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,778.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,159.98
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,958.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,936.78
|
| Rate for Payer: United Healthcare Commercial |
$7,311.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,778.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,159.98
|
| Rate for Payer: Zelis Medicare |
$9,485.98
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,022.26
|
|
|
MS-DRG 42.00: CONCUSSION WITH MCC
|
Facility
|
IP
|
$24,963.84
|
|
|
Service Code
|
MSDRG 088
|
| Min. Negotiated Rate |
$4,019.75 |
| Max. Negotiated Rate |
$24,963.84 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,019.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,426.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,019.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,357.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,684.61
|
| Rate for Payer: GEHA Medicare |
$14,684.61
|
| Rate for Payer: Humana ChoiceCare |
$16,153.07
|
| Rate for Payer: Humana Medicare Advantage |
$14,684.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,670.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,357.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,684.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,963.84
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,558.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,357.88
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,684.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,998.99
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,390.92
|
| Rate for Payer: United Healthcare Commercial |
$9,620.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,357.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,684.61
|
| Rate for Payer: Zelis Medicare |
$12,481.92
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,240.08
|
|
|
MS-DRG 42.00: CONCUSSION WITHOUT CC/MCC
|
Facility
|
IP
|
$15,522.04
|
|
|
Service Code
|
MSDRG 090
|
| Min. Negotiated Rate |
$3,000.90 |
| Max. Negotiated Rate |
$15,522.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,000.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,944.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,000.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,559.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,130.61
|
| Rate for Payer: GEHA Medicare |
$9,130.61
|
| Rate for Payer: Humana ChoiceCare |
$10,043.67
|
| Rate for Payer: Humana Medicare Advantage |
$9,130.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,339.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,559.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,130.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,522.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,782.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,559.26
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,130.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,056.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,948.00
|
| Rate for Payer: United Healthcare Commercial |
$5,846.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,559.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,130.61
|
| Rate for Payer: Zelis Medicare |
$7,761.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,615.31
|
|
|
MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$20,486.75
|
|
|
Service Code
|
MSDRG 546
|
| Min. Negotiated Rate |
$3,971.10 |
| Max. Negotiated Rate |
$20,486.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,971.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,377.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,971.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,271.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,051.03
|
| Rate for Payer: GEHA Medicare |
$12,051.03
|
| Rate for Payer: Humana ChoiceCare |
$13,256.13
|
| Rate for Payer: Humana Medicare Advantage |
$12,051.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,245.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,271.99
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,051.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,486.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,871.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,271.99
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,051.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,232.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,810.01
|
| Rate for Payer: United Healthcare Commercial |
$7,895.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,271.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,051.03
|
| Rate for Payer: Zelis Medicare |
$10,243.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,582.94
|
|
