|
MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH CC
|
Facility
|
IP
|
$16,738.86
|
|
|
Service Code
|
MSDRG 158
|
| Min. Negotiated Rate |
$2,629.20 |
| Max. Negotiated Rate |
$16,738.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,629.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,618.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,629.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,903.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,846.39
|
| Rate for Payer: GEHA Medicare |
$9,846.39
|
| Rate for Payer: Humana ChoiceCare |
$10,831.03
|
| Rate for Payer: Humana Medicare Advantage |
$9,846.39
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,541.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,903.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,846.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,738.86
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,784.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,903.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,846.39
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,080.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,649.46
|
| Rate for Payer: United Healthcare Commercial |
$6,414.89
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,903.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,846.39
|
| Rate for Payer: Zelis Medicare |
$8,369.43
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,160.93
|
|
|
MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH MCC
|
Facility
|
IP
|
$28,977.30
|
|
|
Service Code
|
MSDRG 157
|
| Min. Negotiated Rate |
$3,572.80 |
| Max. Negotiated Rate |
$28,977.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,572.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,263.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,572.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,568.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,045.47
|
| Rate for Payer: GEHA Medicare |
$17,045.47
|
| Rate for Payer: Humana ChoiceCare |
$18,750.02
|
| Rate for Payer: Humana Medicare Advantage |
$17,045.47
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,636.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,568.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,045.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,977.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,863.66
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,568.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,045.47
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,375.02
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,704.56
|
| Rate for Payer: United Healthcare Commercial |
$11,167.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,568.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,045.47
|
| Rate for Payer: Zelis Medicare |
$14,488.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,725.62
|
|
|
MS-DRG 42.00: DENTAL AND ORAL DISEASES WITHOUT CC/MCC
|
Facility
|
IP
|
$12,634.15
|
|
|
Service Code
|
MSDRG 159
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$12,634.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,342.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,968.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,431.85
|
| Rate for Payer: GEHA Medicare |
$7,431.85
|
| Rate for Payer: Humana ChoiceCare |
$8,175.03
|
| Rate for Payer: Humana Medicare Advantage |
$7,431.85
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,485.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,968.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,431.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,634.15
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,404.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,968.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,431.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,627.55
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,283.21
|
| Rate for Payer: United Healthcare Commercial |
$4,498.47
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,968.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,431.85
|
| Rate for Payer: Zelis Medicare |
$6,317.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,320.38
|
|
|
MS-DRG 42.00: DEPRESSIVE NEUROSES
|
Facility
|
IP
|
$16,351.76
|
|
|
Service Code
|
MSDRG 881
|
| Min. Negotiated Rate |
$2,935.80 |
| Max. Negotiated Rate |
$16,351.76 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,935.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,404.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,935.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,444.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,618.68
|
| Rate for Payer: GEHA Medicare |
$9,618.68
|
| Rate for Payer: Humana ChoiceCare |
$10,580.55
|
| Rate for Payer: Humana Medicare Advantage |
$9,618.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,159.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,444.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,618.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,351.76
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,466.15
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,444.34
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,618.68
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,754.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,426.31
|
| Rate for Payer: United Healthcare Commercial |
$6,234.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,444.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,618.68
|
| Rate for Payer: Zelis Medicare |
$8,175.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,987.35
|
|
|
MS-DRG 42.00: DIABETES WITH CC
|
Facility
|
IP
|
$16,397.03
|
|
|
Service Code
|
MSDRG 638
|
| Min. Negotiated Rate |
$3,153.85 |
| Max. Negotiated Rate |
$16,397.03 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,153.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,429.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,153.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,829.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,645.31
|
| Rate for Payer: GEHA Medicare |
$9,645.31
|
| Rate for Payer: Humana ChoiceCare |
$10,609.84
|
| Rate for Payer: Humana Medicare Advantage |
$9,645.31
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,204.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,829.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,645.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,397.03
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,503.43
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,829.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,645.31
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,792.79
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,452.40
|
| Rate for Payer: United Healthcare Commercial |
$6,255.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,829.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,645.31
|
| Rate for Payer: Zelis Medicare |
$8,198.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,007.66
|
|
|
MS-DRG 42.00: DIABETES WITH MCC
|
Facility
|
IP
|
$25,770.79
|
|
|
Service Code
|
MSDRG 637
|
| Min. Negotiated Rate |
$4,936.40 |
| Max. Negotiated Rate |
$25,770.79 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,936.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,796.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,936.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,976.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,159.29
|
| Rate for Payer: GEHA Medicare |
$15,159.29
|
| Rate for Payer: Humana ChoiceCare |
$16,675.22
|
| Rate for Payer: Humana Medicare Advantage |
$15,159.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,467.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,976.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,159.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,770.79
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,223.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,976.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,159.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,677.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,856.10
|
| Rate for Payer: United Healthcare Commercial |
$9,931.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,976.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,159.29
|
| Rate for Payer: Zelis Medicare |
$12,885.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,538.76
|
|
|
MS-DRG 42.00: DIABETES WITHOUT CC/MCC
|
Facility
|
IP
|
$12,152.09
|
|
|
Service Code
|
MSDRG 639
|
| Min. Negotiated Rate |
$2,493.40 |
| Max. Negotiated Rate |
$12,152.09 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,493.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,075.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,493.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,663.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,148.29
|
| Rate for Payer: GEHA Medicare |
$7,148.29
|
| Rate for Payer: Humana ChoiceCare |
$7,863.12
|
| Rate for Payer: Humana Medicare Advantage |
$7,148.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,009.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,663.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,148.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,152.09
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,007.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,663.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,148.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,222.05
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,005.32
|
| Rate for Payer: United Healthcare Commercial |
$4,273.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,663.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,148.29
|
| Rate for Payer: Zelis Medicare |
$6,076.05
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,104.23
|
|
|
MS-DRG 42.00: DIGESTIVE MALIGNANCY WITH CC
|
Facility
|
IP
|
$21,743.17
|
|
|
Service Code
|
MSDRG 375
|
| Min. Negotiated Rate |
$6,582.80 |
| Max. Negotiated Rate |
$21,743.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,582.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,952.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,582.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,882.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,790.10
|
| Rate for Payer: GEHA Medicare |
$12,790.10
|
| Rate for Payer: Humana ChoiceCare |
$14,069.11
|
| Rate for Payer: Humana Medicare Advantage |
$12,790.10
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,487.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,882.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,790.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,743.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,906.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,882.53
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,790.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,289.84
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,534.30
|
| Rate for Payer: United Healthcare Commercial |
$8,379.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,882.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,790.10
|
| Rate for Payer: Zelis Medicare |
$10,871.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,047.98
|
|
|
MS-DRG 42.00: DIGESTIVE MALIGNANCY WITH MCC
|
Facility
|
IP
|
$37,363.47
|
|
|
Service Code
|
MSDRG 374
|
| Min. Negotiated Rate |
$9,440.20 |
| Max. Negotiated Rate |
$37,363.47 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,440.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,102.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,440.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,926.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,978.51
|
| Rate for Payer: GEHA Medicare |
$21,978.51
|
| Rate for Payer: Humana ChoiceCare |
$24,176.36
|
| Rate for Payer: Humana Medicare Advantage |
$21,978.51
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,923.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,926.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,978.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,363.47
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,769.91
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,926.81
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,978.51
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,429.27
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,538.94
|
| Rate for Payer: United Healthcare Commercial |
$14,399.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,926.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,978.51
|
| Rate for Payer: Zelis Medicare |
$18,681.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,829.67
|
|
|
MS-DRG 42.00: DIGESTIVE MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$15,897.45
|
|
|
Service Code
|
MSDRG 376
|
| Min. Negotiated Rate |
$4,761.40 |
| Max. Negotiated Rate |
$15,897.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,761.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,152.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,761.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,667.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,351.44
|
| Rate for Payer: GEHA Medicare |
$9,351.44
|
| Rate for Payer: Humana ChoiceCare |
$10,286.58
|
| Rate for Payer: Humana Medicare Advantage |
$9,351.44
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,710.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,667.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,351.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,897.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,092.02
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,667.14
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,351.44
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,372.56
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,164.41
|
| Rate for Payer: United Healthcare Commercial |
$6,022.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,667.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,351.44
|
| Rate for Payer: Zelis Medicare |
$7,948.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,783.65
|
|
|
MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$17,112.79
|
|
|
Service Code
|
MSDRG 442
|
| Min. Negotiated Rate |
$4,448.85 |
| Max. Negotiated Rate |
$17,112.79 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,448.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,826.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,448.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,115.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,066.35
|
| Rate for Payer: GEHA Medicare |
$10,066.35
|
| Rate for Payer: Humana ChoiceCare |
$11,072.99
|
| Rate for Payer: Humana Medicare Advantage |
$10,066.35
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,911.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,115.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,066.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,112.79
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,092.89
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,115.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,066.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,394.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,865.02
|
| Rate for Payer: United Healthcare Commercial |
$6,589.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,115.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,066.35
|
| Rate for Payer: Zelis Medicare |
$8,556.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,328.61
|
|
|
MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$33,452.65
|
|
|
Service Code
|
MSDRG 441
|
| Min. Negotiated Rate |
$6,124.30 |
| Max. Negotiated Rate |
$33,452.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,124.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,312.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,124.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,073.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,678.03
|
| Rate for Payer: GEHA Medicare |
$19,678.03
|
| Rate for Payer: Humana ChoiceCare |
$21,645.83
|
| Rate for Payer: Humana Medicare Advantage |
$19,678.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$33,059.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,073.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,678.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$33,452.65
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,549.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,073.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,678.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,139.58
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,284.47
|
| Rate for Payer: United Healthcare Commercial |
$12,892.53
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,073.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,678.03
|
| Rate for Payer: Zelis Medicare |
$16,726.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,382.12
|
|
|
MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,263.71
|
|
|
Service Code
|
MSDRG 443
|
| Min. Negotiated Rate |
$3,637.90 |
| Max. Negotiated Rate |
$13,263.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,637.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,691.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,637.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,683.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,802.18
|
| Rate for Payer: GEHA Medicare |
$7,802.18
|
| Rate for Payer: Humana ChoiceCare |
$8,582.40
|
| Rate for Payer: Humana Medicare Advantage |
$7,802.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,107.66
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,683.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,802.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,263.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,923.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,683.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,802.18
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,157.12
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,646.14
|
| Rate for Payer: United Healthcare Commercial |
$4,792.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,683.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,802.18
|
| Rate for Payer: Zelis Medicare |
$6,631.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,602.69
|
|
|
MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC
|
Facility
|
IP
|
$15,564.38
|
|
|
Service Code
|
MSDRG 439
|
| Min. Negotiated Rate |
$4,878.65 |
| Max. Negotiated Rate |
$15,564.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,878.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,967.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,878.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,874.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,155.52
|
| Rate for Payer: GEHA Medicare |
$9,155.52
|
| Rate for Payer: Humana ChoiceCare |
$10,071.07
|
| Rate for Payer: Humana Medicare Advantage |
$9,155.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,381.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,874.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,155.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,564.38
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,817.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,874.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,155.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,092.39
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,972.41
|
| Rate for Payer: United Healthcare Commercial |
$5,866.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,874.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,155.52
|
| Rate for Payer: Zelis Medicare |
$7,782.19
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,634.31
|
|
|
MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC
|
Facility
|
IP
|
$29,440.97
|
|
|
Service Code
|
MSDRG 438
|
| Min. Negotiated Rate |
$6,611.85 |
| Max. Negotiated Rate |
$29,440.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,611.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,475.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,611.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,933.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,318.22
|
| Rate for Payer: GEHA Medicare |
$17,318.22
|
| Rate for Payer: Humana ChoiceCare |
$19,050.04
|
| Rate for Payer: Humana Medicare Advantage |
$17,318.22
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,094.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,933.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,318.22
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,440.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,245.51
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,933.81
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,318.22
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,765.05
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,971.86
|
| Rate for Payer: United Healthcare Commercial |
$11,346.43
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,933.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,318.22
|
| Rate for Payer: Zelis Medicare |
$14,720.49
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,897.24
|
|
|
MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$11,984.08
|
|
|
Service Code
|
MSDRG 440
|
| Min. Negotiated Rate |
$3,853.15 |
| Max. Negotiated Rate |
$11,984.08 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,853.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,982.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,853.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,063.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,049.46
|
| Rate for Payer: GEHA Medicare |
$7,049.46
|
| Rate for Payer: Humana ChoiceCare |
$7,754.41
|
| Rate for Payer: Humana Medicare Advantage |
$7,049.46
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,843.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,063.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,049.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,984.08
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9,869.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,063.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,049.46
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,080.73
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,908.47
|
| Rate for Payer: United Healthcare Commercial |
$4,194.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,063.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,049.46
|
| Rate for Payer: Zelis Medicare |
$5,992.04
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,028.91
|
|
|
MS-DRG 42.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
|
IP
|
$32,806.75
|
|
|
Service Code
|
MSDRG 883
|
| Min. Negotiated Rate |
$4,482.45 |
| Max. Negotiated Rate |
$32,806.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,482.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,016.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,482.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,174.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,298.09
|
| Rate for Payer: GEHA Medicare |
$19,298.09
|
| Rate for Payer: Humana ChoiceCare |
$21,227.90
|
| Rate for Payer: Humana Medicare Advantage |
$19,298.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,420.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,174.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,298.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,806.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,017.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,174.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,298.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,596.27
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,912.13
|
| Rate for Payer: United Healthcare Commercial |
$12,643.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,174.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,298.09
|
| Rate for Payer: Zelis Medicare |
$16,403.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,143.05
|
|
|
MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITH CC
|
Facility
|
IP
|
$19,191.42
|
|
|
Service Code
|
MSDRG 445
|
| Min. Negotiated Rate |
$3,192.35 |
| Max. Negotiated Rate |
$19,191.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,192.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,784.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,192.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,897.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,289.07
|
| Rate for Payer: GEHA Medicare |
$11,289.07
|
| Rate for Payer: Humana ChoiceCare |
$12,417.98
|
| Rate for Payer: Humana Medicare Advantage |
$11,289.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,965.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,897.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,289.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,191.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,804.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,897.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,289.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,143.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,063.29
|
| Rate for Payer: United Healthcare Commercial |
$7,396.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,897.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,289.07
|
| Rate for Payer: Zelis Medicare |
$9,595.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,103.48
|
|
|
MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITH MCC
|
Facility
|
IP
|
$29,807.29
|
|
|
Service Code
|
MSDRG 444
|
| Min. Negotiated Rate |
$4,246.90 |
| Max. Negotiated Rate |
$29,807.29 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,246.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,643.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,246.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,758.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,533.70
|
| Rate for Payer: GEHA Medicare |
$17,533.70
|
| Rate for Payer: Humana ChoiceCare |
$19,287.07
|
| Rate for Payer: Humana Medicare Advantage |
$17,533.70
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,456.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,758.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,533.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,807.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,547.18
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,758.87
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,533.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$25,073.19
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,183.03
|
| Rate for Payer: United Healthcare Commercial |
$11,487.61
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,758.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,533.70
|
| Rate for Payer: Zelis Medicare |
$14,903.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,032.82
|
|
|
MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC
|
Facility
|
IP
|
$14,645.58
|
|
|
Service Code
|
MSDRG 446
|
| Min. Negotiated Rate |
$2,458.75 |
| Max. Negotiated Rate |
$14,645.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,458.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,458.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,458.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,602.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,615.05
|
| Rate for Payer: GEHA Medicare |
$8,615.05
|
| Rate for Payer: Humana ChoiceCare |
$9,476.56
|
| Rate for Payer: Humana Medicare Advantage |
$8,615.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,473.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,602.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,615.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,645.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,061.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,602.18
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,615.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,319.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,442.75
|
| Rate for Payer: United Healthcare Commercial |
$5,437.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,602.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,615.05
|
| Rate for Payer: Zelis Medicare |
$7,322.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,222.31
|
|
|
MS-DRG 42.00: DYSEQUILIBRIUM
|
Facility
|
IP
|
$13,918.16
|
|
|
Service Code
|
MSDRG 149
|
| Min. Negotiated Rate |
$2,480.45 |
| Max. Negotiated Rate |
$13,918.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,480.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,054.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,480.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,640.49
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,187.15
|
| Rate for Payer: GEHA Medicare |
$8,187.15
|
| Rate for Payer: Humana ChoiceCare |
$9,005.86
|
| Rate for Payer: Humana Medicare Advantage |
$8,187.15
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,754.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,640.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,187.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,918.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,462.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,640.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,187.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,707.62
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,023.41
|
| Rate for Payer: United Healthcare Commercial |
$5,097.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,640.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,187.15
|
| Rate for Payer: Zelis Medicare |
$6,959.08
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,896.12
|
|
|
MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC
|
Facility
|
IP
|
$22,028.07
|
|
|
Service Code
|
MSDRG 147
|
| Min. Negotiated Rate |
$6,962.55 |
| Max. Negotiated Rate |
$22,028.07 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,962.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,082.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,962.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,552.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,957.69
|
| Rate for Payer: GEHA Medicare |
$12,957.69
|
| Rate for Payer: Humana ChoiceCare |
$14,253.46
|
| Rate for Payer: Humana Medicare Advantage |
$12,957.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,768.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,552.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,957.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,028.07
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,140.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,552.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,957.69
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,529.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,698.54
|
| Rate for Payer: United Healthcare Commercial |
$8,489.54
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,552.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,957.69
|
| Rate for Payer: Zelis Medicare |
$11,014.04
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,153.44
|
|
|
MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC
|
Facility
|
IP
|
$40,596.54
|
|
|
Service Code
|
MSDRG 146
|
| Min. Negotiated Rate |
$10,376.45 |
| Max. Negotiated Rate |
$40,596.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,376.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,582.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,376.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,579.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,880.32
|
| Rate for Payer: GEHA Medicare |
$23,880.32
|
| Rate for Payer: Humana ChoiceCare |
$26,268.35
|
| Rate for Payer: Humana Medicare Advantage |
$23,880.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$40,118.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,579.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,880.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40,596.54
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$33,432.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,579.61
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,880.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$34,148.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,402.71
|
| Rate for Payer: United Healthcare Commercial |
$15,645.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,579.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,880.32
|
| Rate for Payer: Zelis Medicare |
$20,298.27
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,026.35
|
|
|
MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$14,695.24
|
|
|
Service Code
|
MSDRG 148
|
| Min. Negotiated Rate |
$5,244.59 |
| Max. Negotiated Rate |
$14,695.24 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,561.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,485.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,561.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,080.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,644.26
|
| Rate for Payer: GEHA Medicare |
$8,644.26
|
| Rate for Payer: Humana ChoiceCare |
$9,508.69
|
| Rate for Payer: Humana Medicare Advantage |
$8,644.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,522.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,080.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,644.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,695.24
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,101.96
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,080.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,644.26
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,361.29
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,471.37
|
| Rate for Payer: United Healthcare Commercial |
$5,460.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,080.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,644.26
|
| Rate for Payer: Zelis Medicare |
$7,347.62
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,244.59
|
|
|
MS-DRG 42.00: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES
|
Facility
|
IP
|
$379,255.07
|
|
|
Service Code
|
MSDRG 003
|
| Min. Negotiated Rate |
$106,761.55 |
| Max. Negotiated Rate |
$379,255.07 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$106,761.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$173,595.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$106,761.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$188,732.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$223,091.22
|
| Rate for Payer: GEHA Medicare |
$223,091.22
|
| Rate for Payer: Humana ChoiceCare |
$245,400.34
|
| Rate for Payer: Humana Medicare Advantage |
$223,091.22
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$374,793.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$188,732.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$223,091.22
|
| Rate for Payer: New Mexico Health Connections Medicare |
$379,255.07
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$312,327.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$188,732.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$223,091.22
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$319,020.44
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$218,629.40
|
| Rate for Payer: United Healthcare Commercial |
$146,163.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$188,732.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$223,091.22
|
| Rate for Payer: Zelis Medicare |
$189,627.54
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$140,376.98
|
|
