|
MS-DRG 42.00: FRACTURES OF FEMUR WITHOUT MCC
|
Facility
|
IP
|
$14,889.55
|
|
|
Service Code
|
MSDRG 534
|
| Min. Negotiated Rate |
$4,226.60 |
| Max. Negotiated Rate |
$14,889.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,226.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,593.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,226.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,723.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,758.56
|
| Rate for Payer: GEHA Medicare |
$8,758.56
|
| Rate for Payer: Humana ChoiceCare |
$9,634.42
|
| Rate for Payer: Humana Medicare Advantage |
$8,758.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,714.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,723.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,758.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,889.55
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,261.98
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,723.04
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,758.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,524.74
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,583.39
|
| Rate for Payer: United Healthcare Commercial |
$5,551.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,723.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,758.56
|
| Rate for Payer: Zelis Medicare |
$7,444.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,331.70
|
|
|
MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITH MCC
|
Facility
|
IP
|
$23,534.02
|
|
|
Service Code
|
MSDRG 535
|
| Min. Negotiated Rate |
$5,666.15 |
| Max. Negotiated Rate |
$23,534.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,666.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,772.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,666.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,264.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,843.54
|
| Rate for Payer: GEHA Medicare |
$13,843.54
|
| Rate for Payer: Humana ChoiceCare |
$15,227.89
|
| Rate for Payer: Humana Medicare Advantage |
$13,843.54
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,257.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,264.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,843.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,534.02
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,380.96
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,264.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,843.54
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,796.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,566.67
|
| Rate for Payer: United Healthcare Commercial |
$9,069.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,264.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,843.54
|
| Rate for Payer: Zelis Medicare |
$11,767.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,710.84
|
|
|
MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITHOUT MCC
|
Facility
|
IP
|
$14,844.26
|
|
|
Service Code
|
MSDRG 536
|
| Min. Negotiated Rate |
$3,158.40 |
| Max. Negotiated Rate |
$14,844.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,158.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,568.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,158.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,837.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,731.92
|
| Rate for Payer: GEHA Medicare |
$8,731.92
|
| Rate for Payer: Humana ChoiceCare |
$9,605.11
|
| Rate for Payer: Humana Medicare Advantage |
$8,731.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,669.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,837.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,731.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,844.26
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,224.69
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,837.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,731.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,486.65
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,557.28
|
| Rate for Payer: United Healthcare Commercial |
$5,530.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,837.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,731.92
|
| Rate for Payer: Zelis Medicare |
$7,422.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,311.40
|
|
|
MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC
|
Facility
|
IP
|
$25,898.19
|
|
|
Service Code
|
MSDRG 562
|
| Min. Negotiated Rate |
$4,807.60 |
| Max. Negotiated Rate |
$25,898.19 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,807.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,854.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,807.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,748.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,234.23
|
| Rate for Payer: GEHA Medicare |
$15,234.23
|
| Rate for Payer: Humana ChoiceCare |
$16,757.65
|
| Rate for Payer: Humana Medicare Advantage |
$15,234.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,593.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,748.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,234.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,898.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,327.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,748.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,234.23
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,784.95
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,929.55
|
| Rate for Payer: United Healthcare Commercial |
$9,981.07
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,748.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,234.23
|
| Rate for Payer: Zelis Medicare |
$12,949.10
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,585.92
|
|
|
MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC
|
Facility
|
IP
|
$16,055.21
|
|
|
Service Code
|
MSDRG 563
|
| Min. Negotiated Rate |
$2,405.20 |
| Max. Negotiated Rate |
$16,055.21 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,405.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,239.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,405.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,507.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,444.24
|
| Rate for Payer: GEHA Medicare |
$9,444.24
|
| Rate for Payer: Humana ChoiceCare |
$10,388.66
|
| Rate for Payer: Humana Medicare Advantage |
$9,444.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,866.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,507.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,444.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,055.21
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,221.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,507.65
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,444.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,505.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,255.36
|
| Rate for Payer: United Healthcare Commercial |
$6,095.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,507.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,444.24
|
| Rate for Payer: Zelis Medicare |
$8,027.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,854.39
|
|
|
MS-DRG 42.00: FULL TERM NEONATE WITH MAJOR PROBLEMS
|
Facility
|
IP
|
$73,801.44
|
|
|
Service Code
|
MSDRG 793
|
| Min. Negotiated Rate |
$2,902.55 |
| Max. Negotiated Rate |
$73,801.44 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,902.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33,781.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,902.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,385.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$43,412.61
|
| Rate for Payer: GEHA Medicare |
$43,412.61
|
| Rate for Payer: Humana ChoiceCare |
$47,753.87
|
| Rate for Payer: Humana Medicare Advantage |
$43,412.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$72,933.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,385.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$43,412.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$73,801.44
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$60,777.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,385.64
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$43,412.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$62,080.03
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$42,544.36
|
| Rate for Payer: United Healthcare Commercial |
$28,442.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,385.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$43,412.61
|
| Rate for Payer: Zelis Medicare |
$36,900.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$27,316.78
|
|
|
MS-DRG 42.00: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY
|
Facility
|
IP
|
$37,972.25
|
|
|
Service Code
|
MSDRG 934
|
| Min. Negotiated Rate |
$5,736.50 |
| Max. Negotiated Rate |
$37,972.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,736.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,380.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,736.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,388.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,336.62
|
| Rate for Payer: GEHA Medicare |
$22,336.62
|
| Rate for Payer: Humana ChoiceCare |
$24,570.28
|
| Rate for Payer: Humana Medicare Advantage |
$22,336.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,525.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,388.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,336.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,972.25
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,271.27
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,388.52
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,336.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,941.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,889.89
|
| Rate for Payer: United Healthcare Commercial |
$14,634.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,388.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,336.62
|
| Rate for Payer: Zelis Medicare |
$18,986.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,054.99
|
|
|
MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC
|
Facility
|
IP
|
$118,190.29
|
|
|
Service Code
|
MSDRG 928
|
| Min. Negotiated Rate |
$20,960.80 |
| Max. Negotiated Rate |
$118,190.29 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$20,960.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$54,099.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$20,960.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$37,264.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$69,523.70
|
| Rate for Payer: GEHA Medicare |
$69,523.70
|
| Rate for Payer: Humana ChoiceCare |
$76,476.07
|
| Rate for Payer: Humana Medicare Advantage |
$69,523.70
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$116,799.82
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$37,264.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$69,523.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$118,190.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$97,333.18
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$37,264.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$69,523.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$99,418.89
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$68,133.23
|
| Rate for Payer: United Healthcare Commercial |
$45,550.10
|
| Rate for Payer: United Healthcare Managed Medicaid |
$37,264.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$69,523.70
|
| Rate for Payer: Zelis Medicare |
$59,095.14
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$43,746.79
|
|
|
MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC
|
Facility
|
IP
|
$56,280.57
|
|
|
Service Code
|
MSDRG 929
|
| Min. Negotiated Rate |
$12,899.60 |
| Max. Negotiated Rate |
$56,280.57 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,899.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,761.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,899.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23,033.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$33,106.22
|
| Rate for Payer: GEHA Medicare |
$33,106.22
|
| Rate for Payer: Humana ChoiceCare |
$36,416.84
|
| Rate for Payer: Humana Medicare Advantage |
$33,106.22
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$55,618.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23,033.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$33,106.22
|
| Rate for Payer: New Mexico Health Connections Medicare |
$56,280.57
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$46,348.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23,033.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$33,106.22
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$47,341.89
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$32,444.10
|
| Rate for Payer: United Healthcare Commercial |
$21,690.33
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23,033.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,106.22
|
| Rate for Payer: Zelis Medicare |
$28,140.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,831.62
|
|
|
MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH CC
|
Facility
|
IP
|
$17,446.57
|
|
|
Service Code
|
MSDRG 378
|
| Min. Negotiated Rate |
$3,687.25 |
| Max. Negotiated Rate |
$17,446.57 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,687.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,985.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,687.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,770.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,262.69
|
| Rate for Payer: GEHA Medicare |
$10,262.69
|
| Rate for Payer: Humana ChoiceCare |
$11,288.96
|
| Rate for Payer: Humana Medicare Advantage |
$10,262.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,241.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,770.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,262.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,446.57
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,367.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,770.90
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,262.69
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,675.65
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,057.44
|
| Rate for Payer: United Healthcare Commercial |
$6,723.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,770.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,262.69
|
| Rate for Payer: Zelis Medicare |
$8,723.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,457.65
|
|
|
MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH MCC
|
Facility
|
IP
|
$32,174.98
|
|
|
Service Code
|
MSDRG 377
|
| Min. Negotiated Rate |
$6,888.70 |
| Max. Negotiated Rate |
$32,174.98 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,888.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,727.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,888.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,422.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,926.46
|
| Rate for Payer: GEHA Medicare |
$18,926.46
|
| Rate for Payer: Humana ChoiceCare |
$20,819.11
|
| Rate for Payer: Humana Medicare Advantage |
$18,926.46
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,796.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,422.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,926.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,174.98
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,497.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,422.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,926.46
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,064.84
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,547.93
|
| Rate for Payer: United Healthcare Commercial |
$12,400.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,422.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,926.46
|
| Rate for Payer: Zelis Medicare |
$16,087.49
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,909.21
|
|
|
MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC
|
Facility
|
IP
|
$12,299.64
|
|
|
Service Code
|
MSDRG 379
|
| Min. Negotiated Rate |
$2,671.55 |
| Max. Negotiated Rate |
$12,299.64 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,671.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,157.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,671.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,977.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,235.08
|
| Rate for Payer: GEHA Medicare |
$7,235.08
|
| Rate for Payer: Humana ChoiceCare |
$7,958.59
|
| Rate for Payer: Humana Medicare Advantage |
$7,235.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,154.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,977.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,235.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,299.64
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,129.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,977.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,235.08
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,346.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,090.38
|
| Rate for Payer: United Healthcare Commercial |
$4,342.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,977.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,235.08
|
| Rate for Payer: Zelis Medicare |
$6,149.82
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,170.39
|
|
|
MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH CC
|
Facility
|
IP
|
$14,708.40
|
|
|
Service Code
|
MSDRG 389
|
| Min. Negotiated Rate |
$3,251.85 |
| Max. Negotiated Rate |
$14,708.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,251.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,492.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,251.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,002.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,652.00
|
| Rate for Payer: GEHA Medicare |
$8,652.00
|
| Rate for Payer: Humana ChoiceCare |
$9,517.20
|
| Rate for Payer: Humana Medicare Advantage |
$8,652.00
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,535.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,002.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,652.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,708.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,112.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,002.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,652.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,372.36
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,478.96
|
| Rate for Payer: United Healthcare Commercial |
$5,466.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,002.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,652.00
|
| Rate for Payer: Zelis Medicare |
$7,354.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,250.48
|
|
|
MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH MCC
|
Facility
|
IP
|
$26,011.44
|
|
|
Service Code
|
MSDRG 388
|
| Min. Negotiated Rate |
$5,572.35 |
| Max. Negotiated Rate |
$26,011.44 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,572.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,906.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,572.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,098.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,300.85
|
| Rate for Payer: GEHA Medicare |
$15,300.85
|
| Rate for Payer: Humana ChoiceCare |
$16,830.94
|
| Rate for Payer: Humana Medicare Advantage |
$15,300.85
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,705.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,098.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,300.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,011.44
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,421.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,098.74
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,300.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,880.22
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,994.83
|
| Rate for Payer: United Healthcare Commercial |
$10,024.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,098.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,300.85
|
| Rate for Payer: Zelis Medicare |
$13,005.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,627.84
|
|
|
MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC
|
Facility
|
IP
|
$10,992.25
|
|
|
Service Code
|
MSDRG 390
|
| Min. Negotiated Rate |
$2,193.80 |
| Max. Negotiated Rate |
$10,992.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,193.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,432.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,193.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,134.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,466.03
|
| Rate for Payer: GEHA Medicare |
$6,466.03
|
| Rate for Payer: Humana ChoiceCare |
$7,112.63
|
| Rate for Payer: Humana Medicare Advantage |
$6,466.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$10,862.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,134.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,466.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10,992.25
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9,052.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,134.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,466.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9,246.42
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,336.71
|
| Rate for Payer: United Healthcare Commercial |
$3,731.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,134.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,466.03
|
| Rate for Payer: Zelis Medicare |
$5,496.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,584.16
|
|
|
MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$26,643.20
|
|
|
Service Code
|
MSDRG 513
|
| Min. Negotiated Rate |
$4,599.35 |
| Max. Negotiated Rate |
$26,643.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,599.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,195.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,599.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,381.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,672.47
|
| Rate for Payer: GEHA Medicare |
$15,672.47
|
| Rate for Payer: Humana ChoiceCare |
$17,239.72
|
| Rate for Payer: Humana Medicare Advantage |
$15,672.47
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,329.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,381.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,672.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,643.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,941.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,381.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,672.47
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,411.63
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,359.02
|
| Rate for Payer: United Healthcare Commercial |
$10,268.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,381.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,672.47
|
| Rate for Payer: Zelis Medicare |
$13,321.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,861.68
|
|
|
MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,042.92
|
|
|
Service Code
|
MSDRG 514
|
| Min. Negotiated Rate |
$4,015.20 |
| Max. Negotiated Rate |
$18,042.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,015.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,258.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,015.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,349.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,613.48
|
| Rate for Payer: GEHA Medicare |
$10,613.48
|
| Rate for Payer: Humana ChoiceCare |
$11,674.83
|
| Rate for Payer: Humana Medicare Advantage |
$10,613.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,830.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,349.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,613.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,042.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,858.87
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,349.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,613.48
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,177.28
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,401.21
|
| Rate for Payer: United Healthcare Commercial |
$6,953.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,349.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,613.48
|
| Rate for Payer: Zelis Medicare |
$9,021.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,678.38
|
|
|
MS-DRG 42.00: HAND PROCEDURES FOR INJURIES
|
Facility
|
IP
|
$38,621.69
|
|
|
Service Code
|
MSDRG 906
|
| Min. Negotiated Rate |
$4,108.30 |
| Max. Negotiated Rate |
$38,621.69 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,108.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,678.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,108.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,514.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,718.64
|
| Rate for Payer: GEHA Medicare |
$22,718.64
|
| Rate for Payer: Humana ChoiceCare |
$24,990.50
|
| Rate for Payer: Humana Medicare Advantage |
$22,718.64
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$38,167.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,514.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,718.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$38,621.69
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,806.10
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,514.20
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,718.64
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$32,487.66
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,264.27
|
| Rate for Payer: United Healthcare Commercial |
$14,884.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,514.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,718.64
|
| Rate for Payer: Zelis Medicare |
$19,310.84
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,295.38
|
|
|
MS-DRG 42.00: HEADACHES WITH MCC
|
Facility
|
IP
|
$20,518.59
|
|
|
Service Code
|
MSDRG 102
|
| Min. Negotiated Rate |
$3,014.90 |
| Max. Negotiated Rate |
$20,518.59 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,014.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,391.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,014.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,583.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,069.76
|
| Rate for Payer: GEHA Medicare |
$12,069.76
|
| Rate for Payer: Humana ChoiceCare |
$13,276.74
|
| Rate for Payer: Humana Medicare Advantage |
$12,069.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,277.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,583.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,069.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,518.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,897.66
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,583.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,069.76
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,259.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,828.36
|
| Rate for Payer: United Healthcare Commercial |
$7,907.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,583.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,069.76
|
| Rate for Payer: Zelis Medicare |
$10,259.30
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,594.73
|
|
|
MS-DRG 42.00: HEADACHES WITHOUT MCC
|
Facility
|
IP
|
$15,418.34
|
|
|
Service Code
|
MSDRG 103
|
| Min. Negotiated Rate |
$2,315.60 |
| Max. Negotiated Rate |
$15,418.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,315.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,886.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,315.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,349.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,069.61
|
| Rate for Payer: GEHA Medicare |
$9,069.61
|
| Rate for Payer: Humana ChoiceCare |
$9,976.57
|
| Rate for Payer: Humana Medicare Advantage |
$9,069.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,236.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,349.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,069.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,418.34
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,697.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,349.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,069.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,969.54
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,888.22
|
| Rate for Payer: United Healthcare Commercial |
$5,798.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,349.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,069.61
|
| Rate for Payer: Zelis Medicare |
$7,709.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,568.81
|
|
|
MS-DRG 42.00: HEART FAILURE AND SHOCK WITH CC
|
Facility
|
IP
|
$15,579.02
|
|
|
Service Code
|
MSDRG 292
|
| Min. Negotiated Rate |
$4,326.35 |
| Max. Negotiated Rate |
$15,579.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,326.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,975.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,326.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,899.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,164.13
|
| Rate for Payer: GEHA Medicare |
$9,164.13
|
| Rate for Payer: Humana ChoiceCare |
$10,080.54
|
| Rate for Payer: Humana Medicare Advantage |
$9,164.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,395.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,899.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,164.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,579.02
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,829.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,899.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,164.13
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,104.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,980.85
|
| Rate for Payer: United Healthcare Commercial |
$5,873.38
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,899.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,164.13
|
| Rate for Payer: Zelis Medicare |
$7,789.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,640.86
|
|
|
MS-DRG 42.00: HEART FAILURE AND SHOCK WITH MCC
|
Facility
|
IP
|
$23,089.81
|
|
|
Service Code
|
MSDRG 291
|
| Min. Negotiated Rate |
$6,558.30 |
| Max. Negotiated Rate |
$23,089.81 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,558.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,568.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,558.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,839.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,582.24
|
| Rate for Payer: GEHA Medicare |
$13,582.24
|
| Rate for Payer: Humana ChoiceCare |
$14,940.46
|
| Rate for Payer: Humana Medicare Advantage |
$13,582.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,818.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,839.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,582.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,089.81
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,015.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,839.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,582.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,422.60
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,310.60
|
| Rate for Payer: United Healthcare Commercial |
$8,898.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,839.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,582.24
|
| Rate for Payer: Zelis Medicare |
$11,544.90
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,546.44
|
|
|
MS-DRG 42.00: HEART FAILURE AND SHOCK WITHOUT CC/MCC
|
Facility
|
IP
|
$11,014.15
|
|
|
Service Code
|
MSDRG 293
|
| Min. Negotiated Rate |
$2,899.05 |
| Max. Negotiated Rate |
$11,014.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,899.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,444.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,899.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,379.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,478.91
|
| Rate for Payer: GEHA Medicare |
$6,478.91
|
| Rate for Payer: Humana ChoiceCare |
$7,126.80
|
| Rate for Payer: Humana Medicare Advantage |
$6,478.91
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$10,884.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,379.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,478.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,014.15
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9,070.47
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,379.46
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,478.91
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9,264.84
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,349.33
|
| Rate for Payer: United Healthcare Commercial |
$3,742.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,379.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,478.91
|
| Rate for Payer: Zelis Medicare |
$5,507.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,593.99
|
|
|
MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC
|
Facility
|
IP
|
$498,468.20
|
|
|
Service Code
|
MSDRG 001
|
| Min. Negotiated Rate |
$129,924.55 |
| Max. Negotiated Rate |
$498,468.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$129,924.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$228,163.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$129,924.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$229,622.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$293,216.59
|
| Rate for Payer: GEHA Medicare |
$293,216.59
|
| Rate for Payer: Humana ChoiceCare |
$322,538.25
|
| Rate for Payer: Humana Medicare Advantage |
$293,216.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$492,603.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$229,622.66
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$293,216.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$498,468.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$410,503.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$229,622.66
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$293,216.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$419,299.72
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$287,352.26
|
| Rate for Payer: United Healthcare Commercial |
$192,107.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$229,622.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$293,216.59
|
| Rate for Payer: Zelis Medicare |
$249,234.10
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$184,502.36
|
|
|
MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$195,005.39
|
|
|
Service Code
|
MSDRG 002
|
| Min. Negotiated Rate |
$70,729.40 |
| Max. Negotiated Rate |
$195,005.39 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$70,729.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$89,259.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$70,729.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$125,123.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$114,709.05
|
| Rate for Payer: GEHA Medicare |
$114,709.05
|
| Rate for Payer: Humana ChoiceCare |
$126,179.96
|
| Rate for Payer: Humana Medicare Advantage |
$114,709.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$192,711.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$125,123.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$114,709.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$195,005.39
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$160,592.67
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$125,123.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$114,709.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$164,033.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$112,414.87
|
| Rate for Payer: United Healthcare Commercial |
$75,154.35
|
| Rate for Payer: United Healthcare Managed Medicaid |
$125,123.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$114,709.05
|
| Rate for Payer: Zelis Medicare |
$97,502.69
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$72,179.04
|
|
