|
MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$44,716.22
|
|
|
Service Code
|
MSDRG 545
|
| Min. Negotiated Rate |
$9,523.85 |
| Max. Negotiated Rate |
$44,716.22 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,523.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,467.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,523.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,074.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,303.66
|
| Rate for Payer: GEHA Medicare |
$26,303.66
|
| Rate for Payer: Humana ChoiceCare |
$28,934.03
|
| Rate for Payer: Humana Medicare Advantage |
$26,303.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$44,190.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,074.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,303.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$44,716.22
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$36,825.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,074.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,303.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37,614.23
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$25,777.59
|
| Rate for Payer: United Healthcare Commercial |
$17,233.46
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,074.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,303.66
|
| Rate for Payer: Zelis Medicare |
$22,358.11
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,551.19
|
|
|
MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,899.15
|
|
|
Service Code
|
MSDRG 547
|
| Min. Negotiated Rate |
$2,399.95 |
| Max. Negotiated Rate |
$13,899.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,399.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,044.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,399.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,498.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,175.97
|
| Rate for Payer: GEHA Medicare |
$8,175.97
|
| Rate for Payer: Humana ChoiceCare |
$8,993.57
|
| Rate for Payer: Humana Medicare Advantage |
$8,175.97
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,735.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,498.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,175.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,899.15
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,446.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,498.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,175.97
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,691.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,012.45
|
| Rate for Payer: United Healthcare Commercial |
$5,089.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,498.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,175.97
|
| Rate for Payer: Zelis Medicare |
$6,949.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,887.61
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC
|
Facility
|
IP
|
$138,319.57
|
|
|
Service Code
|
MSDRG 233
|
| Min. Negotiated Rate |
$33,958.05 |
| Max. Negotiated Rate |
$138,319.57 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$33,958.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$63,312.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$33,958.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$60,209.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$81,364.45
|
| Rate for Payer: GEHA Medicare |
$81,364.45
|
| Rate for Payer: Humana ChoiceCare |
$89,500.90
|
| Rate for Payer: Humana Medicare Advantage |
$81,364.45
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$136,692.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$60,209.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$81,364.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$138,319.57
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$113,910.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$60,209.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$81,364.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$116,351.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$79,737.16
|
| Rate for Payer: United Healthcare Commercial |
$53,307.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$60,209.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81,364.45
|
| Rate for Payer: Zelis Medicare |
$69,159.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$51,197.42
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC
|
Facility
|
IP
|
$94,146.63
|
|
|
Service Code
|
MSDRG 234
|
| Min. Negotiated Rate |
$30,651.25 |
| Max. Negotiated Rate |
$94,146.63 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$30,651.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$43,093.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$30,651.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$54,371.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$55,380.37
|
| Rate for Payer: GEHA Medicare |
$55,380.37
|
| Rate for Payer: Humana ChoiceCare |
$60,918.41
|
| Rate for Payer: Humana Medicare Advantage |
$55,380.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$93,039.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$54,371.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$55,380.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$94,146.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$77,532.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$54,371.53
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$55,380.37
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$79,193.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$54,272.76
|
| Rate for Payer: United Healthcare Commercial |
$36,283.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$54,371.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$55,380.37
|
| Rate for Payer: Zelis Medicare |
$47,073.31
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$34,847.31
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$104,127.19
|
|
|
Service Code
|
MSDRG 235
|
| Min. Negotiated Rate |
$31,613.05 |
| Max. Negotiated Rate |
$104,127.19 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$31,613.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$47,662.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$31,613.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$56,069.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$61,251.29
|
| Rate for Payer: GEHA Medicare |
$61,251.29
|
| Rate for Payer: Humana ChoiceCare |
$67,376.42
|
| Rate for Payer: Humana Medicare Advantage |
$61,251.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$102,902.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$56,069.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$61,251.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$104,127.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$85,751.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$56,069.43
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$61,251.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$87,589.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$60,026.26
|
| Rate for Payer: United Healthcare Commercial |
$40,130.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$56,069.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$61,251.29
|
| Rate for Payer: Zelis Medicare |
$52,063.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$38,541.51
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$72,768.01
|
|
|
Service Code
|
MSDRG 236
|
| Min. Negotiated Rate |
$26,934.26 |
| Max. Negotiated Rate |
$72,768.01 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27,372.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33,308.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27,372.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48,582.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$42,804.71
|
| Rate for Payer: GEHA Medicare |
$42,804.71
|
| Rate for Payer: Humana ChoiceCare |
$47,085.18
|
| Rate for Payer: Humana Medicare Advantage |
$42,804.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$71,911.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$48,582.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$42,804.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$72,768.01
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$59,926.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$48,582.71
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$42,804.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$61,210.74
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$41,948.62
|
| Rate for Payer: United Healthcare Commercial |
$28,044.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$48,582.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42,804.71
|
| Rate for Payer: Zelis Medicare |
$36,384.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$26,934.26
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
|
IP
|
$149,954.70
|
|
|
Service Code
|
MSDRG 231
|
| Min. Negotiated Rate |
$41,552.70 |
| Max. Negotiated Rate |
$149,954.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$41,552.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$68,638.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$41,552.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$73,616.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$88,208.65
|
| Rate for Payer: GEHA Medicare |
$88,208.65
|
| Rate for Payer: Humana ChoiceCare |
$97,029.51
|
| Rate for Payer: Humana Medicare Advantage |
$88,208.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$148,190.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$73,616.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$88,208.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$149,954.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$123,492.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$73,616.29
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$88,208.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$126,138.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$86,444.48
|
| Rate for Payer: United Healthcare Commercial |
$57,792.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$73,616.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$88,208.65
|
| Rate for Payer: Zelis Medicare |
$74,977.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$55,504.04
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
|
IP
|
$108,099.99
|
|
|
Service Code
|
MSDRG 232
|
| Min. Negotiated Rate |
$35,227.50 |
| Max. Negotiated Rate |
$108,099.99 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$35,227.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$49,480.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$35,227.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62,450.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$63,588.23
|
| Rate for Payer: GEHA Medicare |
$63,588.23
|
| Rate for Payer: Humana ChoiceCare |
$69,947.05
|
| Rate for Payer: Humana Medicare Advantage |
$63,588.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$106,828.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$62,450.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$63,588.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$108,099.99
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$89,023.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$62,450.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$63,588.23
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$90,931.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$62,316.47
|
| Rate for Payer: United Healthcare Commercial |
$41,661.33
|
| Rate for Payer: United Healthcare Managed Medicaid |
$62,450.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63,588.23
|
| Rate for Payer: Zelis Medicare |
$54,050.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$40,011.99
|
|
|
MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$75,374.63
|
|
|
Service Code
|
MSDRG 323
|
| Min. Negotiated Rate |
$14,490.00 |
| Max. Negotiated Rate |
$75,374.63 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,490.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$34,501.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,490.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25,841.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$44,338.02
|
| Rate for Payer: GEHA Medicare |
$44,338.02
|
| Rate for Payer: Humana ChoiceCare |
$48,771.82
|
| Rate for Payer: Humana Medicare Advantage |
$44,338.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$74,487.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25,841.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$44,338.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$75,374.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$62,073.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25,841.43
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$44,338.02
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$63,403.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$43,451.26
|
| Rate for Payer: United Healthcare Commercial |
$29,049.11
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25,841.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$44,338.02
|
| Rate for Payer: Zelis Medicare |
$37,687.32
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$27,899.07
|
|
|
MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$56,540.71
|
|
|
Service Code
|
MSDRG 324
|
| Min. Negotiated Rate |
$10,390.10 |
| Max. Negotiated Rate |
$56,540.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,390.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,880.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,390.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,603.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$33,259.24
|
| Rate for Payer: GEHA Medicare |
$33,259.24
|
| Rate for Payer: Humana ChoiceCare |
$36,585.16
|
| Rate for Payer: Humana Medicare Advantage |
$33,259.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$55,875.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,603.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$33,259.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$56,540.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$46,562.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,603.71
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$33,259.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$47,560.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$32,594.06
|
| Rate for Payer: United Healthcare Commercial |
$21,790.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,603.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,259.24
|
| Rate for Payer: Zelis Medicare |
$28,270.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,927.90
|
|
|
MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$50,647.90
|
|
|
Service Code
|
MSDRG 325
|
| Min. Negotiated Rate |
$9,255.05 |
| Max. Negotiated Rate |
$50,647.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,255.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,183.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,255.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,599.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29,792.88
|
| Rate for Payer: GEHA Medicare |
$29,792.88
|
| Rate for Payer: Humana ChoiceCare |
$32,772.17
|
| Rate for Payer: Humana Medicare Advantage |
$29,792.88
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$50,052.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,599.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29,792.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$50,647.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$41,710.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,599.96
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29,792.88
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$42,603.82
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,197.02
|
| Rate for Payer: United Healthcare Commercial |
$19,519.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,599.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,792.88
|
| Rate for Payer: Zelis Medicare |
$25,323.95
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18,746.76
|
|
|
MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC
|
Facility
|
IP
|
$27,351.03
|
|
|
Service Code
|
MSDRG 073
|
| Min. Negotiated Rate |
$3,347.75 |
| Max. Negotiated Rate |
$27,351.03 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,347.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,519.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,347.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,171.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,088.84
|
| Rate for Payer: GEHA Medicare |
$16,088.84
|
| Rate for Payer: Humana ChoiceCare |
$17,697.72
|
| Rate for Payer: Humana Medicare Advantage |
$16,088.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,029.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,171.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,088.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,351.03
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,524.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,171.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,088.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,007.04
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,767.06
|
| Rate for Payer: United Healthcare Commercial |
$10,540.99
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,171.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,088.84
|
| Rate for Payer: Zelis Medicare |
$13,675.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,123.68
|
|
|
MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$18,446.39
|
|
|
Service Code
|
MSDRG 074
|
| Min. Negotiated Rate |
$2,927.75 |
| Max. Negotiated Rate |
$18,446.39 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,927.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,443.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,927.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,430.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,850.82
|
| Rate for Payer: GEHA Medicare |
$10,850.82
|
| Rate for Payer: Humana ChoiceCare |
$11,935.90
|
| Rate for Payer: Humana Medicare Advantage |
$10,850.82
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,229.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,430.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,850.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,446.39
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,191.15
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,430.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,850.82
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,516.67
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,633.80
|
| Rate for Payer: United Healthcare Commercial |
$7,109.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,430.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,850.82
|
| Rate for Payer: Zelis Medicare |
$9,223.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,827.72
|
|
|
MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$54,125.21
|
|
|
Service Code
|
MSDRG 026
|
| Min. Negotiated Rate |
$20,033.83 |
| Max. Negotiated Rate |
$54,125.21 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$21,008.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$24,774.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$21,008.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$37,348.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$31,838.36
|
| Rate for Payer: GEHA Medicare |
$31,838.36
|
| Rate for Payer: Humana ChoiceCare |
$35,022.20
|
| Rate for Payer: Humana Medicare Advantage |
$31,838.36
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$53,488.44
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$37,348.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$31,838.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$54,125.21
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$44,573.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$37,348.62
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$31,838.36
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$45,528.85
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$31,201.59
|
| Rate for Payer: United Healthcare Commercial |
$20,859.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$37,348.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31,838.36
|
| Rate for Payer: Zelis Medicare |
$27,062.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,033.83
|
|
|
MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$79,142.14
|
|
|
Service Code
|
MSDRG 025
|
| Min. Negotiated Rate |
$28,683.55 |
| Max. Negotiated Rate |
$79,142.14 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$28,683.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$36,225.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$28,683.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$50,897.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$46,554.20
|
| Rate for Payer: GEHA Medicare |
$46,554.20
|
| Rate for Payer: Humana ChoiceCare |
$51,209.62
|
| Rate for Payer: Humana Medicare Advantage |
$46,554.20
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$78,211.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$50,897.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$46,554.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$79,142.14
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$65,175.88
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$50,897.87
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$46,554.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$66,572.51
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$45,623.12
|
| Rate for Payer: United Healthcare Commercial |
$30,501.09
|
| Rate for Payer: United Healthcare Managed Medicaid |
$50,897.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$46,554.20
|
| Rate for Payer: Zelis Medicare |
$39,571.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$29,293.56
|
|
|
MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$43,670.36
|
|
|
Service Code
|
MSDRG 027
|
| Min. Negotiated Rate |
$16,164.09 |
| Max. Negotiated Rate |
$43,670.36 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$17,690.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,989.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$17,690.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$31,491.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$25,688.45
|
| Rate for Payer: GEHA Medicare |
$25,688.45
|
| Rate for Payer: Humana ChoiceCare |
$28,257.29
|
| Rate for Payer: Humana Medicare Advantage |
$25,688.45
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$43,156.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$31,491.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$25,688.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$43,670.36
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$35,963.83
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$31,491.22
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$25,688.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$36,734.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$25,174.68
|
| Rate for Payer: United Healthcare Commercial |
$16,830.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$31,491.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,688.45
|
| Rate for Payer: Zelis Medicare |
$21,835.18
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,164.09
|
|
|
MS-DRG 42.00: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$120,834.06
|
|
|
Service Code
|
MSDRG 955
|
| Min. Negotiated Rate |
$28,076.30 |
| Max. Negotiated Rate |
$120,834.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$28,076.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$55,309.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$28,076.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$49,825.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$71,078.86
|
| Rate for Payer: GEHA Medicare |
$71,078.86
|
| Rate for Payer: Humana ChoiceCare |
$78,186.75
|
| Rate for Payer: Humana Medicare Advantage |
$71,078.86
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$119,412.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49,825.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$71,078.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$120,834.06
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$99,510.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49,825.87
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$71,078.86
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$101,642.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$69,657.28
|
| Rate for Payer: United Healthcare Commercial |
$46,569.01
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49,825.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$71,078.86
|
| Rate for Payer: Zelis Medicare |
$60,417.03
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$44,725.36
|
|
|
MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$100,957.87
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$29,187.55 |
| Max. Negotiated Rate |
$100,957.87 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$29,187.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$46,211.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$29,187.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$51,787.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$59,386.98
|
| Rate for Payer: GEHA Medicare |
$59,386.98
|
| Rate for Payer: Humana ChoiceCare |
$65,325.68
|
| Rate for Payer: Humana Medicare Advantage |
$59,386.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$99,770.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51,787.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$59,386.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$100,957.87
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$83,141.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51,787.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$59,386.98
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$84,923.38
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58,199.24
|
| Rate for Payer: United Healthcare Commercial |
$38,908.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51,787.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59,386.98
|
| Rate for Payer: Zelis Medicare |
$50,478.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$37,368.40
|
|
|
MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$67,275.12
|
|
|
Service Code
|
MSDRG 024
|
| Min. Negotiated Rate |
$24,901.13 |
| Max. Negotiated Rate |
$67,275.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$26,611.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$30,793.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$26,611.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$47,239.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$39,573.60
|
| Rate for Payer: GEHA Medicare |
$39,573.60
|
| Rate for Payer: Humana ChoiceCare |
$43,530.96
|
| Rate for Payer: Humana Medicare Advantage |
$39,573.60
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$66,483.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$47,239.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$39,573.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$67,275.12
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$55,403.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$47,239.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$39,573.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$56,590.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$38,782.13
|
| Rate for Payer: United Healthcare Commercial |
$25,927.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$47,239.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39,573.60
|
| Rate for Payer: Zelis Medicare |
$33,637.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$24,901.13
|
|
|
MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC
|
Facility
|
IP
|
$34,578.15
|
|
|
Service Code
|
MSDRG 744
|
| Min. Negotiated Rate |
$4,565.75 |
| Max. Negotiated Rate |
$34,578.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,565.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,827.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,565.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,321.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,340.09
|
| Rate for Payer: GEHA Medicare |
$20,340.09
|
| Rate for Payer: Humana ChoiceCare |
$22,374.10
|
| Rate for Payer: Humana Medicare Advantage |
$20,340.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,171.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,321.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,340.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,578.15
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,476.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,321.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,340.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,086.33
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,933.29
|
| Rate for Payer: United Healthcare Commercial |
$13,326.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,321.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,340.09
|
| Rate for Payer: Zelis Medicare |
$17,289.08
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,798.70
|
|
|
MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC
|
Facility
|
IP
|
$18,134.95
|
|
|
Service Code
|
MSDRG 745
|
| Min. Negotiated Rate |
$3,547.25 |
| Max. Negotiated Rate |
$18,134.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,547.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,300.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,547.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,523.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,667.62
|
| Rate for Payer: GEHA Medicare |
$10,667.62
|
| Rate for Payer: Humana ChoiceCare |
$11,734.38
|
| Rate for Payer: Humana Medicare Advantage |
$10,667.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,921.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,523.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,667.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,134.95
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,934.67
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,523.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,667.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,254.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,454.27
|
| Rate for Payer: United Healthcare Commercial |
$6,989.14
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,523.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,667.62
|
| Rate for Payer: Zelis Medicare |
$9,067.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,712.44
|
|
|
MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC
|
Facility
|
IP
|
$21,730.76
|
|
|
Service Code
|
MSDRG 294
|
| Min. Negotiated Rate |
$4,392.50 |
| Max. Negotiated Rate |
$21,730.76 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,946.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,015.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,782.80
|
| Rate for Payer: GEHA Medicare |
$12,782.80
|
| Rate for Payer: Humana ChoiceCare |
$14,061.08
|
| Rate for Payer: Humana Medicare Advantage |
$12,782.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,475.10
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,015.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,782.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,730.76
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,895.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,015.91
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,782.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,279.40
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,527.14
|
| Rate for Payer: United Healthcare Commercial |
$8,374.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,015.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,782.80
|
| Rate for Payer: Zelis Medicare |
$10,865.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,043.40
|
|
|
MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$14,536.04
|
|
|
Service Code
|
MSDRG 295
|
| Min. Negotiated Rate |
$3,278.80 |
| Max. Negotiated Rate |
$14,536.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,278.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,397.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,278.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,049.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,550.61
|
| Rate for Payer: GEHA Medicare |
$8,550.61
|
| Rate for Payer: Humana ChoiceCare |
$9,405.67
|
| Rate for Payer: Humana Medicare Advantage |
$8,550.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,365.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,049.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,550.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,536.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,970.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,049.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,550.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,227.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,379.60
|
| Rate for Payer: United Healthcare Commercial |
$5,386.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,049.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,550.61
|
| Rate for Payer: Zelis Medicare |
$7,268.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,173.19
|
|
|
MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC
|
Facility
|
IP
|
$44,312.74
|
|
|
Service Code
|
MSDRG 056
|
| Min. Negotiated Rate |
$5,051.55 |
| Max. Negotiated Rate |
$44,312.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,051.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,283.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,051.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,179.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,066.32
|
| Rate for Payer: GEHA Medicare |
$26,066.32
|
| Rate for Payer: Humana ChoiceCare |
$28,672.95
|
| Rate for Payer: Humana Medicare Advantage |
$26,066.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$43,791.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,179.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,066.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$44,312.74
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$36,492.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,179.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,066.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37,274.84
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$25,544.99
|
| Rate for Payer: United Healthcare Commercial |
$17,077.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,179.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,066.32
|
| Rate for Payer: Zelis Medicare |
$22,156.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,401.85
|
|
|
MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$23,613.65
|
|
|
Service Code
|
MSDRG 057
|
| Min. Negotiated Rate |
$3,595.90 |
| Max. Negotiated Rate |
$23,613.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,595.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,808.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,595.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,609.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,890.38
|
| Rate for Payer: GEHA Medicare |
$13,890.38
|
| Rate for Payer: Humana ChoiceCare |
$15,279.42
|
| Rate for Payer: Humana Medicare Advantage |
$13,890.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,335.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,609.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,890.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,613.65
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,446.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,609.64
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,890.38
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,863.24
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,612.57
|
| Rate for Payer: United Healthcare Commercial |
$9,100.61
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,609.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,890.38
|
| Rate for Payer: Zelis Medicare |
$11,806.82
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,740.32
|
|
