|
MS-DRG 42.00: ENDOCRINE DISORDERS WITH CC
|
Facility
|
IP
|
$18,287.12
|
|
|
Service Code
|
MSDRG 644
|
| Min. Negotiated Rate |
$4,121.25 |
| Max. Negotiated Rate |
$18,287.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,121.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,370.54
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,121.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,537.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,757.13
|
| Rate for Payer: GEHA Medicare |
$10,757.13
|
| Rate for Payer: Humana ChoiceCare |
$11,832.84
|
| Rate for Payer: Humana Medicare Advantage |
$10,757.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,071.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,537.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,757.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,287.12
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,059.98
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,537.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,757.13
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,382.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,541.99
|
| Rate for Payer: United Healthcare Commercial |
$7,047.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,537.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,757.13
|
| Rate for Payer: Zelis Medicare |
$9,143.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,768.77
|
|
|
MS-DRG 42.00: ENDOCRINE DISORDERS WITH MCC
|
Facility
|
IP
|
$29,327.70
|
|
|
Service Code
|
MSDRG 643
|
| Min. Negotiated Rate |
$5,821.20 |
| Max. Negotiated Rate |
$29,327.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,821.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,424.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,821.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,538.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,251.59
|
| Rate for Payer: GEHA Medicare |
$17,251.59
|
| Rate for Payer: Humana ChoiceCare |
$18,976.75
|
| Rate for Payer: Humana Medicare Advantage |
$17,251.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,982.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,538.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,251.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,327.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,152.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,538.05
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,251.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,669.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,906.56
|
| Rate for Payer: United Healthcare Commercial |
$11,302.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,538.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,251.59
|
| Rate for Payer: Zelis Medicare |
$14,663.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,855.32
|
|
|
MS-DRG 42.00: ENDOCRINE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$14,373.87
|
|
|
Service Code
|
MSDRG 645
|
| Min. Negotiated Rate |
$3,644.20 |
| Max. Negotiated Rate |
$14,373.87 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,644.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,307.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,644.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,694.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,455.22
|
| Rate for Payer: GEHA Medicare |
$8,455.22
|
| Rate for Payer: Humana ChoiceCare |
$9,300.74
|
| Rate for Payer: Humana Medicare Advantage |
$8,455.22
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,204.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,694.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,455.22
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,373.87
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,837.31
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,694.90
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,455.22
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,090.96
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,286.12
|
| Rate for Payer: United Healthcare Commercial |
$5,310.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,694.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,455.22
|
| Rate for Payer: Zelis Medicare |
$7,186.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,100.48
|
|
|
MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$106,013.60
|
|
|
Service Code
|
MSDRG 266
|
| Min. Negotiated Rate |
$39,239.74 |
| Max. Negotiated Rate |
$106,013.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$40,462.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$48,525.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$40,462.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$71,692.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$62,360.94
|
| Rate for Payer: GEHA Medicare |
$62,360.94
|
| Rate for Payer: Humana ChoiceCare |
$68,597.03
|
| Rate for Payer: Humana Medicare Advantage |
$62,360.94
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$104,766.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71,692.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$62,360.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$106,013.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$87,305.32
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71,692.25
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$62,360.94
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$89,176.14
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$61,113.72
|
| Rate for Payer: United Healthcare Commercial |
$40,857.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71,692.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$62,360.94
|
| Rate for Payer: Zelis Medicare |
$53,006.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$39,239.74
|
|
|
MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$83,254.71
|
|
|
Service Code
|
MSDRG 267
|
| Min. Negotiated Rate |
$26,800.55 |
| Max. Negotiated Rate |
$83,254.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$26,800.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$38,108.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$26,800.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$47,573.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$48,973.36
|
| Rate for Payer: GEHA Medicare |
$48,973.36
|
| Rate for Payer: Humana ChoiceCare |
$53,870.70
|
| Rate for Payer: Humana Medicare Advantage |
$48,973.36
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$82,275.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$47,573.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$48,973.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$83,254.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$68,562.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$47,573.73
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$48,973.36
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70,031.90
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$47,993.89
|
| Rate for Payer: United Healthcare Commercial |
$32,086.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$47,573.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48,973.36
|
| Rate for Payer: Zelis Medicare |
$41,627.36
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$30,815.78
|
|
|
MS-DRG 42.00: EPISTAXIS WITH MCC
|
Facility
|
IP
|
$24,459.51
|
|
|
Service Code
|
MSDRG 150
|
| Min. Negotiated Rate |
$5,057.50 |
| Max. Negotiated Rate |
$24,459.51 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,057.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,195.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,057.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,189.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,387.95
|
| Rate for Payer: GEHA Medicare |
$14,387.95
|
| Rate for Payer: Humana ChoiceCare |
$15,826.75
|
| Rate for Payer: Humana Medicare Advantage |
$14,387.95
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,171.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,189.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,387.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,459.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,143.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,189.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,387.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,574.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,100.19
|
| Rate for Payer: United Healthcare Commercial |
$9,426.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,189.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,387.95
|
| Rate for Payer: Zelis Medicare |
$12,229.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,053.41
|
|
|
MS-DRG 42.00: EPISTAXIS WITHOUT MCC
|
Facility
|
IP
|
$14,071.53
|
|
|
Service Code
|
MSDRG 151
|
| Min. Negotiated Rate |
$2,409.40 |
| Max. Negotiated Rate |
$14,071.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,409.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,139.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,409.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,515.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,277.37
|
| Rate for Payer: GEHA Medicare |
$8,277.37
|
| Rate for Payer: Humana ChoiceCare |
$9,105.11
|
| Rate for Payer: Humana Medicare Advantage |
$8,277.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,905.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,515.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,277.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,071.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,588.32
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,515.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,277.37
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,836.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,111.82
|
| Rate for Payer: United Healthcare Commercial |
$5,169.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,515.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,277.37
|
| Rate for Payer: Zelis Medicare |
$7,035.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,964.90
|
|
|
MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC
|
Facility
|
IP
|
$22,730.56
|
|
|
Service Code
|
MSDRG 391
|
| Min. Negotiated Rate |
$2,832.20 |
| Max. Negotiated Rate |
$22,730.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,832.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,404.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,832.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,261.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,370.92
|
| Rate for Payer: GEHA Medicare |
$13,370.92
|
| Rate for Payer: Humana ChoiceCare |
$14,708.01
|
| Rate for Payer: Humana Medicare Advantage |
$13,370.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,463.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,261.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,370.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,730.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,719.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,261.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,370.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,120.42
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,103.50
|
| Rate for Payer: United Healthcare Commercial |
$8,760.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,261.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,370.92
|
| Rate for Payer: Zelis Medicare |
$11,365.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,413.48
|
|
|
MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$14,397.27
|
|
|
Service Code
|
MSDRG 392
|
| Min. Negotiated Rate |
$2,497.60 |
| Max. Negotiated Rate |
$14,397.27 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,497.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,320.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,497.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,670.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,468.98
|
| Rate for Payer: GEHA Medicare |
$8,468.98
|
| Rate for Payer: Humana ChoiceCare |
$9,315.88
|
| Rate for Payer: Humana Medicare Advantage |
$8,468.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,227.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,670.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,468.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,397.27
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,856.57
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,670.76
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,468.98
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,110.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,299.60
|
| Rate for Payer: United Healthcare Commercial |
$5,321.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,670.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,468.98
|
| Rate for Payer: Zelis Medicare |
$7,198.63
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,110.97
|
|
|
MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$76,569.10
|
|
|
Service Code
|
MSDRG 933
|
| Min. Negotiated Rate |
$14,607.60 |
| Max. Negotiated Rate |
$76,569.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,607.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$35,047.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,607.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26,049.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$45,040.65
|
| Rate for Payer: GEHA Medicare |
$45,040.65
|
| Rate for Payer: Humana ChoiceCare |
$49,544.71
|
| Rate for Payer: Humana Medicare Advantage |
$45,040.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$75,668.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26,049.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$45,040.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$76,569.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$63,056.91
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26,049.03
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$45,040.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$64,408.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$44,139.84
|
| Rate for Payer: United Healthcare Commercial |
$29,509.46
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26,049.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45,040.65
|
| Rate for Payer: Zelis Medicare |
$38,284.55
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$28,341.19
|
|
|
MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT
|
Facility
|
IP
|
$419,800.35
|
|
|
Service Code
|
MSDRG 927
|
| Min. Negotiated Rate |
$91,991.20 |
| Max. Negotiated Rate |
$419,800.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$91,991.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$192,154.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$91,991.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$162,657.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$246,941.38
|
| Rate for Payer: GEHA Medicare |
$246,941.38
|
| Rate for Payer: Humana ChoiceCare |
$271,635.52
|
| Rate for Payer: Humana Medicare Advantage |
$246,941.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$414,861.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$162,657.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$246,941.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$419,800.35
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$345,717.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$162,657.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$246,941.38
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$353,126.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$242,002.55
|
| Rate for Payer: United Healthcare Commercial |
$161,789.50
|
| Rate for Payer: United Healthcare Managed Medicaid |
$162,657.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$246,941.38
|
| Rate for Payer: Zelis Medicare |
$209,900.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$155,384.34
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$43,325.30
|
|
|
Service Code
|
MSDRG 982
|
| Min. Negotiated Rate |
$8,783.95 |
| Max. Negotiated Rate |
$43,325.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,783.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,831.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,783.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,768.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$25,485.47
|
| Rate for Payer: GEHA Medicare |
$25,485.47
|
| Rate for Payer: Humana ChoiceCare |
$28,034.02
|
| Rate for Payer: Humana Medicare Advantage |
$25,485.47
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$42,815.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,768.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$25,485.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$43,325.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$35,679.66
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,768.31
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$25,485.47
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$36,444.22
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,975.76
|
| Rate for Payer: United Healthcare Commercial |
$16,697.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,768.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,485.47
|
| Rate for Payer: Zelis Medicare |
$21,662.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,036.36
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$84,125.35
|
|
|
Service Code
|
MSDRG 981
|
| Min. Negotiated Rate |
$17,236.80 |
| Max. Negotiated Rate |
$84,125.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$17,236.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$38,506.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$17,236.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$30,690.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$49,485.50
|
| Rate for Payer: GEHA Medicare |
$49,485.50
|
| Rate for Payer: Humana ChoiceCare |
$54,434.05
|
| Rate for Payer: Humana Medicare Advantage |
$49,485.50
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$83,135.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$30,690.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$49,485.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$84,125.35
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$69,279.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$30,690.46
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$49,485.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70,764.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$48,495.79
|
| Rate for Payer: United Healthcare Commercial |
$32,421.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$30,690.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$49,485.50
|
| Rate for Payer: Zelis Medicare |
$42,062.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$31,138.04
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$29,520.62
|
|
|
Service Code
|
MSDRG 983
|
| Min. Negotiated Rate |
$5,089.00 |
| Max. Negotiated Rate |
$29,520.62 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,089.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,512.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,089.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,245.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,365.07
|
| Rate for Payer: GEHA Medicare |
$17,365.07
|
| Rate for Payer: Humana ChoiceCare |
$19,101.58
|
| Rate for Payer: Humana Medicare Advantage |
$17,365.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,173.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,245.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,365.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,520.62
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,311.10
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,245.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,365.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,832.05
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,017.77
|
| Rate for Payer: United Healthcare Commercial |
$11,377.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,245.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,365.07
|
| Rate for Payer: Zelis Medicare |
$14,760.31
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,926.71
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$28,513.67
|
|
|
Service Code
|
MSDRG 038
|
| Min. Negotiated Rate |
$8,568.35 |
| Max. Negotiated Rate |
$28,513.67 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,568.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,051.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,568.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,387.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,772.75
|
| Rate for Payer: GEHA Medicare |
$16,772.75
|
| Rate for Payer: Humana ChoiceCare |
$18,450.03
|
| Rate for Payer: Humana Medicare Advantage |
$16,772.75
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,178.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,387.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,772.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,513.67
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,481.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,387.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,772.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,985.03
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,437.29
|
| Rate for Payer: United Healthcare Commercial |
$10,989.07
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,387.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,772.75
|
| Rate for Payer: Zelis Medicare |
$14,256.84
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,554.01
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$58,766.88
|
|
|
Service Code
|
MSDRG 037
|
| Min. Negotiated Rate |
$11,626.65 |
| Max. Negotiated Rate |
$58,766.88 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,626.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$26,899.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,626.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,786.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$34,568.75
|
| Rate for Payer: GEHA Medicare |
$34,568.75
|
| Rate for Payer: Humana ChoiceCare |
$38,025.62
|
| Rate for Payer: Humana Medicare Advantage |
$34,568.75
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58,075.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,786.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$34,568.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$58,766.88
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$48,396.25
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,786.64
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$34,568.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$49,433.31
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$33,877.38
|
| Rate for Payer: United Healthcare Commercial |
$22,648.54
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,786.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34,568.75
|
| Rate for Payer: Zelis Medicare |
$29,383.44
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21,751.90
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,141.69
|
|
|
Service Code
|
MSDRG 039
|
| Min. Negotiated Rate |
$7,332.85 |
| Max. Negotiated Rate |
$20,141.69 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,332.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,219.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,332.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,206.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,848.05
|
| Rate for Payer: GEHA Medicare |
$11,848.05
|
| Rate for Payer: Humana ChoiceCare |
$13,032.85
|
| Rate for Payer: Humana Medicare Advantage |
$11,848.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,904.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,206.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,848.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,141.69
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,587.27
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,206.62
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,848.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,942.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,611.09
|
| Rate for Payer: United Healthcare Commercial |
$7,762.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,206.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,848.05
|
| Rate for Payer: Zelis Medicare |
$10,070.84
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,455.21
|
|
|
MS-DRG 42.00: EXTRAOCULAR PROCEDURES EXCEPT ORBIT
|
Facility
|
IP
|
$27,092.66
|
|
|
Service Code
|
MSDRG 115
|
| Min. Negotiated Rate |
$4,413.85 |
| Max. Negotiated Rate |
$27,092.66 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,413.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,401.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,413.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,053.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,936.86
|
| Rate for Payer: GEHA Medicare |
$15,936.86
|
| Rate for Payer: Humana ChoiceCare |
$17,530.55
|
| Rate for Payer: Humana Medicare Advantage |
$15,936.86
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,773.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,053.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,936.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,092.66
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,311.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,053.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,936.86
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,789.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,618.12
|
| Rate for Payer: United Healthcare Commercial |
$10,441.42
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,053.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,936.86
|
| Rate for Payer: Zelis Medicare |
$13,546.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,028.05
|
|
|
MS-DRG 42.00: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE
|
Facility
|
IP
|
$105,199.59
|
|
|
Service Code
|
MSDRG 790
|
| Min. Negotiated Rate |
$23,502.50 |
| Max. Negotiated Rate |
$105,199.59 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$23,502.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$48,152.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$23,502.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41,751.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$61,882.11
|
| Rate for Payer: GEHA Medicare |
$61,882.11
|
| Rate for Payer: Humana ChoiceCare |
$68,070.32
|
| Rate for Payer: Humana Medicare Advantage |
$61,882.11
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$103,961.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$41,751.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$61,882.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$105,199.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$86,634.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$41,751.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$61,882.11
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$88,491.42
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$60,644.47
|
| Rate for Payer: United Healthcare Commercial |
$40,543.54
|
| Rate for Payer: United Healthcare Managed Medicaid |
$41,751.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$61,882.11
|
| Rate for Payer: Zelis Medicare |
$52,599.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$38,938.44
|
|
|
MS-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
|
Facility
|
IP
|
$24,107.36
|
|
|
Service Code
|
MSDRG 748
|
| Min. Negotiated Rate |
$3,818.85 |
| Max. Negotiated Rate |
$24,107.36 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,818.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,034.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,818.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,003.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,180.80
|
| Rate for Payer: GEHA Medicare |
$14,180.80
|
| Rate for Payer: Humana ChoiceCare |
$15,598.88
|
| Rate for Payer: Humana Medicare Advantage |
$14,180.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,823.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,003.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,180.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,107.36
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,853.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,003.22
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,180.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,278.54
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,897.18
|
| Rate for Payer: United Healthcare Commercial |
$9,290.89
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,003.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,180.80
|
| Rate for Payer: Zelis Medicare |
$12,053.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,923.07
|
|
|
MS-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS
|
Facility
|
IP
|
$16,116.58
|
|
|
Service Code
|
MSDRG 864
|
| Min. Negotiated Rate |
$4,079.60 |
| Max. Negotiated Rate |
$16,116.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,079.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,273.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,079.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,463.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,480.34
|
| Rate for Payer: GEHA Medicare |
$9,480.34
|
| Rate for Payer: Humana ChoiceCare |
$10,428.37
|
| Rate for Payer: Humana Medicare Advantage |
$9,480.34
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,926.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,463.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,480.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,116.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,272.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,463.53
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,480.34
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,556.89
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,290.73
|
| Rate for Payer: United Healthcare Commercial |
$6,124.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,463.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,480.34
|
| Rate for Payer: Zelis Medicare |
$8,058.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,881.90
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITH CC
|
Facility
|
IP
|
$31,056.60
|
|
|
Service Code
|
MSDRG 504
|
| Min. Negotiated Rate |
$5,010.95 |
| Max. Negotiated Rate |
$31,056.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,010.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,215.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,010.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,107.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,268.59
|
| Rate for Payer: GEHA Medicare |
$18,268.59
|
| Rate for Payer: Humana ChoiceCare |
$20,095.45
|
| Rate for Payer: Humana Medicare Advantage |
$18,268.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,691.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,107.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,268.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,056.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,576.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,107.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,268.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,124.08
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,903.22
|
| Rate for Payer: United Healthcare Commercial |
$11,969.10
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,107.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,268.59
|
| Rate for Payer: Zelis Medicare |
$15,528.30
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,495.25
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITH MCC
|
Facility
|
IP
|
$46,834.40
|
|
|
Service Code
|
MSDRG 503
|
| Min. Negotiated Rate |
$7,643.30 |
| Max. Negotiated Rate |
$46,834.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,643.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21,437.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,643.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,754.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$27,549.65
|
| Rate for Payer: GEHA Medicare |
$27,549.65
|
| Rate for Payer: Humana ChoiceCare |
$30,304.62
|
| Rate for Payer: Humana Medicare Advantage |
$27,549.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$46,283.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,754.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$27,549.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46,834.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$38,569.51
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,754.67
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$27,549.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$39,396.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$26,998.66
|
| Rate for Payer: United Healthcare Commercial |
$18,049.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,754.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,549.65
|
| Rate for Payer: Zelis Medicare |
$23,417.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,335.23
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$31,056.60
|
|
|
Service Code
|
MSDRG 505
|
| Min. Negotiated Rate |
$3,452.05 |
| Max. Negotiated Rate |
$31,056.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,452.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,215.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,452.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,355.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,268.59
|
| Rate for Payer: GEHA Medicare |
$18,268.59
|
| Rate for Payer: Humana ChoiceCare |
$20,095.45
|
| Rate for Payer: Humana Medicare Advantage |
$18,268.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,691.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,355.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,268.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,056.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,576.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,355.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,268.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,124.08
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,903.22
|
| Rate for Payer: United Healthcare Commercial |
$11,969.10
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,355.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,268.59
|
| Rate for Payer: Zelis Medicare |
$15,528.30
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,495.25
|
|
|
MS-DRG 42.00: FRACTURES OF FEMUR WITH MCC
|
Facility
|
IP
|
$26,984.75
|
|
|
Service Code
|
MSDRG 533
|
| Min. Negotiated Rate |
$7,743.05 |
| Max. Negotiated Rate |
$26,984.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,743.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,351.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,743.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,930.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,873.38
|
| Rate for Payer: GEHA Medicare |
$15,873.38
|
| Rate for Payer: Humana ChoiceCare |
$17,460.72
|
| Rate for Payer: Humana Medicare Advantage |
$15,873.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,667.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,930.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,873.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,984.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,222.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,930.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,873.38
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,698.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,555.91
|
| Rate for Payer: United Healthcare Commercial |
$10,399.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,930.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,873.38
|
| Rate for Payer: Zelis Medicare |
$13,492.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,988.09
|
|
