|
MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
|
IP
|
$28,979.08
|
|
|
Service Code
|
MSDRG 421
|
| Min. Negotiated Rate |
$10,726.28 |
| Max. Negotiated Rate |
$28,979.08 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,127.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,264.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,127.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21,670.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,046.52
|
| Rate for Payer: GEHA Medicare |
$17,046.52
|
| Rate for Payer: Humana ChoiceCare |
$18,751.17
|
| Rate for Payer: Humana Medicare Advantage |
$17,046.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,638.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21,670.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,046.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,979.08
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,865.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21,670.19
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,046.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,376.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,705.59
|
| Rate for Payer: United Healthcare Commercial |
$11,168.43
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21,670.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,046.52
|
| Rate for Payer: Zelis Medicare |
$14,489.54
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,726.28
|
|
|
MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$62,458.27
|
|
|
Service Code
|
MSDRG 420
|
| Min. Negotiated Rate |
$15,666.70 |
| Max. Negotiated Rate |
$62,458.27 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15,666.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,588.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15,666.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$27,918.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$36,740.16
|
| Rate for Payer: GEHA Medicare |
$36,740.16
|
| Rate for Payer: Humana ChoiceCare |
$40,414.18
|
| Rate for Payer: Humana Medicare Advantage |
$36,740.16
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$61,723.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$27,918.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$36,740.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$62,458.27
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$51,436.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$27,918.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$36,740.16
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$52,538.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$36,005.36
|
| Rate for Payer: United Healthcare Commercial |
$24,071.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$27,918.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,740.16
|
| Rate for Payer: Zelis Medicare |
$31,229.14
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23,118.22
|
|
|
MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$26,002.59
|
|
|
Service Code
|
MSDRG 422
|
| Min. Negotiated Rate |
$9,598.75 |
| Max. Negotiated Rate |
$26,002.59 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,598.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,902.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,598.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,206.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,295.64
|
| Rate for Payer: GEHA Medicare |
$15,295.64
|
| Rate for Payer: Humana ChoiceCare |
$16,825.20
|
| Rate for Payer: Humana Medicare Advantage |
$15,295.64
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,696.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,206.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,295.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,002.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,413.90
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,206.71
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,295.64
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,872.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,989.73
|
| Rate for Payer: United Healthcare Commercial |
$10,021.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,206.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,295.64
|
| Rate for Payer: Zelis Medicare |
$13,001.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,624.57
|
|
|
MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC
|
Facility
|
IP
|
$30,102.78
|
|
|
Service Code
|
MSDRG 354
|
| Min. Negotiated Rate |
$4,738.30 |
| Max. Negotiated Rate |
$30,102.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,738.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,778.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,738.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,626.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,707.52
|
| Rate for Payer: GEHA Medicare |
$17,707.52
|
| Rate for Payer: Humana ChoiceCare |
$19,478.27
|
| Rate for Payer: Humana Medicare Advantage |
$17,707.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,748.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,626.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,707.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30,102.78
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,790.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,626.36
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,707.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$25,321.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,353.37
|
| Rate for Payer: United Healthcare Commercial |
$11,601.50
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,626.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,707.52
|
| Rate for Payer: Zelis Medicare |
$15,051.39
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,142.20
|
|
|
MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC
|
Facility
|
IP
|
$51,902.56
|
|
|
Service Code
|
MSDRG 353
|
| Min. Negotiated Rate |
$9,313.50 |
| Max. Negotiated Rate |
$51,902.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,313.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,757.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,313.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,703.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$30,530.92
|
| Rate for Payer: GEHA Medicare |
$30,530.92
|
| Rate for Payer: Humana ChoiceCare |
$33,584.01
|
| Rate for Payer: Humana Medicare Advantage |
$30,530.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$51,291.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,703.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$30,530.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$51,902.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$42,743.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,703.14
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$30,530.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$43,659.22
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,920.30
|
| Rate for Payer: United Healthcare Commercial |
$20,003.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,703.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,530.92
|
| Rate for Payer: Zelis Medicare |
$25,951.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19,211.15
|
|
|
MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC
|
Facility
|
IP
|
$23,592.41
|
|
|
Service Code
|
MSDRG 355
|
| Min. Negotiated Rate |
$4,115.65 |
| Max. Negotiated Rate |
$23,592.41 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,115.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,798.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,115.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,527.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,877.89
|
| Rate for Payer: GEHA Medicare |
$13,877.89
|
| Rate for Payer: Humana ChoiceCare |
$15,265.68
|
| Rate for Payer: Humana Medicare Advantage |
$13,877.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,314.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,527.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,877.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,592.41
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,429.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,527.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,877.89
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,845.38
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,600.33
|
| Rate for Payer: United Healthcare Commercial |
$9,092.42
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,527.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,877.89
|
| Rate for Payer: Zelis Medicare |
$11,796.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,732.46
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$36,717.59
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$10,491.95 |
| Max. Negotiated Rate |
$36,717.59 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,491.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,806.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,491.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,783.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,598.58
|
| Rate for Payer: GEHA Medicare |
$21,598.58
|
| Rate for Payer: Humana ChoiceCare |
$23,758.44
|
| Rate for Payer: Humana Medicare Advantage |
$21,598.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,285.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,783.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,598.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$36,717.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,238.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,783.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,598.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$30,885.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,166.61
|
| Rate for Payer: United Healthcare Commercial |
$14,150.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,783.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,598.58
|
| Rate for Payer: Zelis Medicare |
$18,358.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,590.59
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
|
IP
|
$52,044.16
|
|
|
Service Code
|
MSDRG 480
|
| Min. Negotiated Rate |
$14,570.15 |
| Max. Negotiated Rate |
$52,044.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,570.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,822.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,570.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25,982.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$30,614.21
|
| Rate for Payer: GEHA Medicare |
$30,614.21
|
| Rate for Payer: Humana ChoiceCare |
$33,675.63
|
| Rate for Payer: Humana Medicare Advantage |
$30,614.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$51,431.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25,982.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$30,614.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$52,044.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$42,859.89
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25,982.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$30,614.21
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$43,778.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$30,001.93
|
| Rate for Payer: United Healthcare Commercial |
$20,057.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25,982.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,614.21
|
| Rate for Payer: Zelis Medicare |
$26,022.08
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19,263.55
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
|
IP
|
$28,073.05
|
|
|
Service Code
|
MSDRG 482
|
| Min. Negotiated Rate |
$9,196.95 |
| Max. Negotiated Rate |
$28,073.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,196.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,849.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,196.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,497.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,513.56
|
| Rate for Payer: GEHA Medicare |
$16,513.56
|
| Rate for Payer: Humana ChoiceCare |
$18,164.92
|
| Rate for Payer: Humana Medicare Advantage |
$16,513.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,742.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,497.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,513.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,073.05
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,118.98
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,497.39
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,513.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,614.39
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,183.29
|
| Rate for Payer: United Healthcare Commercial |
$10,819.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,497.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,513.56
|
| Rate for Payer: Zelis Medicare |
$14,036.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,390.92
|
|
|
MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
|
IP
|
$51,578.75
|
|
|
Service Code
|
MSDRG 521
|
| Min. Negotiated Rate |
$19,091.28 |
| Max. Negotiated Rate |
$51,578.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$23,223.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,609.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$23,223.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41,259.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$30,340.44
|
| Rate for Payer: GEHA Medicare |
$30,340.44
|
| Rate for Payer: Humana ChoiceCare |
$33,374.48
|
| Rate for Payer: Humana Medicare Advantage |
$30,340.44
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$50,971.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$41,259.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$30,340.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$51,578.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$42,476.62
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$41,259.73
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$30,340.44
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$43,386.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,733.63
|
| Rate for Payer: United Healthcare Commercial |
$19,878.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$41,259.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,340.44
|
| Rate for Payer: Zelis Medicare |
$25,789.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19,091.28
|
|
|
MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
|
IP
|
$37,305.09
|
|
|
Service Code
|
MSDRG 522
|
| Min. Negotiated Rate |
$13,808.06 |
| Max. Negotiated Rate |
$37,305.09 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$17,139.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,075.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$17,139.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$30,519.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,944.17
|
| Rate for Payer: GEHA Medicare |
$21,944.17
|
| Rate for Payer: Humana ChoiceCare |
$24,138.59
|
| Rate for Payer: Humana Medicare Advantage |
$21,944.17
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,866.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$30,519.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,944.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,305.09
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,721.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$30,519.31
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,944.17
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,380.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,505.29
|
| Rate for Payer: United Healthcare Commercial |
$14,377.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$30,519.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,944.17
|
| Rate for Payer: Zelis Medicare |
$18,652.54
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,808.06
|
|
|
MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$111,915.25
|
|
|
Service Code
|
MSDRG 969
|
| Min. Negotiated Rate |
$41,424.17 |
| Max. Negotiated Rate |
$111,915.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$44,454.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$51,226.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$44,454.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$78,739.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$65,832.50
|
| Rate for Payer: GEHA Medicare |
$65,832.50
|
| Rate for Payer: Humana ChoiceCare |
$72,415.75
|
| Rate for Payer: Humana Medicare Advantage |
$65,832.50
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$110,598.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$78,739.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$65,832.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$111,915.25
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$92,165.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$78,739.05
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$65,832.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$94,140.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$64,515.85
|
| Rate for Payer: United Healthcare Commercial |
$43,131.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$78,739.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$65,832.50
|
| Rate for Payer: Zelis Medicare |
$55,957.62
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$41,424.17
|
|
|
MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$60,195.56
|
|
|
Service Code
|
MSDRG 970
|
| Min. Negotiated Rate |
$17,379.12 |
| Max. Negotiated Rate |
$60,195.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$33,950.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21,491.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$33,950.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$60,195.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$27,619.40
|
| Rate for Payer: GEHA Medicare |
$27,619.40
|
| Rate for Payer: Humana ChoiceCare |
$30,381.34
|
| Rate for Payer: Humana Medicare Advantage |
$27,619.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$46,400.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$60,195.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$27,619.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46,952.98
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$38,667.16
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$60,195.56
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$27,619.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$39,495.74
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27,067.01
|
| Rate for Payer: United Healthcare Commercial |
$18,095.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$60,195.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,619.40
|
| Rate for Payer: Zelis Medicare |
$23,476.49
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,379.12
|
|
|
MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH CC
|
Facility
|
IP
|
$25,153.20
|
|
|
Service Code
|
MSDRG 975
|
| Min. Negotiated Rate |
$7,309.40 |
| Max. Negotiated Rate |
$25,153.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,309.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,513.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,309.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,165.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,796.00
|
| Rate for Payer: GEHA Medicare |
$14,796.00
|
| Rate for Payer: Humana ChoiceCare |
$16,275.60
|
| Rate for Payer: Humana Medicare Advantage |
$14,796.00
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,857.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,165.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,796.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,153.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,714.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,165.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,796.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,158.28
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,500.08
|
| Rate for Payer: United Healthcare Commercial |
$9,693.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,165.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,796.00
|
| Rate for Payer: Zelis Medicare |
$12,576.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,310.17
|
|
|
MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH MCC
|
Facility
|
IP
|
$52,844.01
|
|
|
Service Code
|
MSDRG 974
|
| Min. Negotiated Rate |
$10,309.60 |
| Max. Negotiated Rate |
$52,844.01 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,309.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$24,188.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,309.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,461.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$31,084.71
|
| Rate for Payer: GEHA Medicare |
$31,084.71
|
| Rate for Payer: Humana ChoiceCare |
$34,193.18
|
| Rate for Payer: Humana Medicare Advantage |
$31,084.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$52,222.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,461.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$31,084.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$52,844.01
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$43,518.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,461.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$31,084.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$44,451.14
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$30,463.02
|
| Rate for Payer: United Healthcare Commercial |
$20,365.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,461.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31,084.71
|
| Rate for Payer: Zelis Medicare |
$26,422.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19,559.61
|
|
|
MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC
|
Facility
|
IP
|
$17,749.17
|
|
|
Service Code
|
MSDRG 976
|
| Min. Negotiated Rate |
$5,579.00 |
| Max. Negotiated Rate |
$17,749.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,579.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,124.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,579.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,110.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,440.69
|
| Rate for Payer: GEHA Medicare |
$10,440.69
|
| Rate for Payer: Humana ChoiceCare |
$11,484.76
|
| Rate for Payer: Humana Medicare Advantage |
$10,440.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,540.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,110.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,440.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,749.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,616.97
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,110.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,440.69
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,930.19
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,231.88
|
| Rate for Payer: United Healthcare Commercial |
$6,840.46
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,110.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,440.69
|
| Rate for Payer: Zelis Medicare |
$8,874.59
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,569.65
|
|
|
MS-DRG 42.00: HIV WITH OR WITHOUT OTHER RELATED CONDITION
|
Facility
|
IP
|
$25,515.96
|
|
|
Service Code
|
MSDRG 977
|
| Min. Negotiated Rate |
$4,568.90 |
| Max. Negotiated Rate |
$25,515.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,568.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,679.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,568.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,327.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,009.39
|
| Rate for Payer: GEHA Medicare |
$15,009.39
|
| Rate for Payer: Humana ChoiceCare |
$16,510.33
|
| Rate for Payer: Humana Medicare Advantage |
$15,009.39
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,215.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,327.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,009.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,515.96
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,013.15
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,327.31
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,009.39
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,463.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,709.20
|
| Rate for Payer: United Healthcare Commercial |
$9,833.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,327.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,009.39
|
| Rate for Payer: Zelis Medicare |
$12,757.98
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,444.44
|
|
|
MS-DRG 42.00: HYPERTENSION WITH MCC
|
Facility
|
IP
|
$20,789.33
|
|
|
Service Code
|
MSDRG 304
|
| Min. Negotiated Rate |
$4,193.35 |
| Max. Negotiated Rate |
$20,789.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,193.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,515.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,193.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,664.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,229.02
|
| Rate for Payer: GEHA Medicare |
$12,229.02
|
| Rate for Payer: Humana ChoiceCare |
$13,451.92
|
| Rate for Payer: Humana Medicare Advantage |
$12,229.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,544.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,664.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,229.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,789.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,120.63
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,664.34
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,229.02
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,487.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,984.44
|
| Rate for Payer: United Healthcare Commercial |
$8,012.14
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,664.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,229.02
|
| Rate for Payer: Zelis Medicare |
$10,394.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,694.94
|
|
|
MS-DRG 42.00: HYPERTENSION WITHOUT MCC
|
Facility
|
IP
|
$13,964.87
|
|
|
Service Code
|
MSDRG 305
|
| Min. Negotiated Rate |
$3,123.75 |
| Max. Negotiated Rate |
$13,964.87 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,123.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,080.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,123.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,776.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,214.63
|
| Rate for Payer: GEHA Medicare |
$8,214.63
|
| Rate for Payer: Humana ChoiceCare |
$9,036.09
|
| Rate for Payer: Humana Medicare Advantage |
$8,214.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,800.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,776.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,214.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,964.87
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,500.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,776.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,214.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,746.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,050.34
|
| Rate for Payer: United Healthcare Commercial |
$5,119.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,776.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,214.63
|
| Rate for Payer: Zelis Medicare |
$6,982.44
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,917.09
|
|
|
MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH CC
|
Facility
|
IP
|
$17,658.92
|
|
|
Service Code
|
MSDRG 078
|
| Min. Negotiated Rate |
$3,579.80 |
| Max. Negotiated Rate |
$17,658.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,579.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,082.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,579.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,581.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,387.60
|
| Rate for Payer: GEHA Medicare |
$10,387.60
|
| Rate for Payer: Humana ChoiceCare |
$11,426.36
|
| Rate for Payer: Humana Medicare Advantage |
$10,387.60
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,451.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,581.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,387.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,658.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,542.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,581.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,387.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,854.27
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,179.85
|
| Rate for Payer: United Healthcare Commercial |
$6,805.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,581.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,387.60
|
| Rate for Payer: Zelis Medicare |
$8,829.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,536.24
|
|
|
MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH MCC
|
Facility
|
IP
|
$27,363.42
|
|
|
Service Code
|
MSDRG 077
|
| Min. Negotiated Rate |
$4,440.10 |
| Max. Negotiated Rate |
$27,363.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,440.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,525.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,440.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,099.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,096.13
|
| Rate for Payer: GEHA Medicare |
$16,096.13
|
| Rate for Payer: Humana ChoiceCare |
$17,705.74
|
| Rate for Payer: Humana Medicare Advantage |
$16,096.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,041.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,099.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,096.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,363.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,534.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,099.94
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,096.13
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,017.47
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,774.21
|
| Rate for Payer: United Healthcare Commercial |
$10,545.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,099.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,096.13
|
| Rate for Payer: Zelis Medicare |
$13,681.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,128.26
|
|
|
MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC
|
Facility
|
IP
|
$12,737.86
|
|
|
Service Code
|
MSDRG 079
|
| Min. Negotiated Rate |
$2,654.40 |
| Max. Negotiated Rate |
$12,737.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,654.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,400.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,654.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,947.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,492.86
|
| Rate for Payer: GEHA Medicare |
$7,492.86
|
| Rate for Payer: Humana ChoiceCare |
$8,242.15
|
| Rate for Payer: Humana Medicare Advantage |
$7,492.86
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,588.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,947.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,492.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,737.86
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,490.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,947.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,492.86
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,714.79
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,343.00
|
| Rate for Payer: United Healthcare Commercial |
$4,546.89
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,947.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,492.86
|
| Rate for Payer: Zelis Medicare |
$6,368.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,366.89
|
|
|
MS-DRG 42.00: INBORN AND OTHER DISORDERS OF METABOLISM
|
Facility
|
IP
|
$21,962.57
|
|
|
Service Code
|
MSDRG 642
|
| Min. Negotiated Rate |
$5,518.45 |
| Max. Negotiated Rate |
$21,962.57 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,518.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,052.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,518.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,003.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,919.16
|
| Rate for Payer: GEHA Medicare |
$12,919.16
|
| Rate for Payer: Humana ChoiceCare |
$14,211.08
|
| Rate for Payer: Humana Medicare Advantage |
$12,919.16
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,704.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,003.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,919.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,962.57
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,086.82
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,003.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,919.16
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,474.40
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,660.78
|
| Rate for Payer: United Healthcare Commercial |
$8,464.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,003.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,919.16
|
| Rate for Payer: Zelis Medicare |
$10,981.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,129.20
|
|
|
MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$18,037.61
|
|
|
Service Code
|
MSDRG 758
|
| Min. Negotiated Rate |
$2,796.50 |
| Max. Negotiated Rate |
$18,037.61 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,796.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,256.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,796.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,198.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,610.36
|
| Rate for Payer: GEHA Medicare |
$10,610.36
|
| Rate for Payer: Humana ChoiceCare |
$11,671.40
|
| Rate for Payer: Humana Medicare Advantage |
$10,610.36
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,825.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,198.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,610.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,037.61
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,854.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,198.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,610.36
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,172.81
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,398.15
|
| Rate for Payer: United Healthcare Commercial |
$6,951.63
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,198.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,610.36
|
| Rate for Payer: Zelis Medicare |
$9,018.81
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,676.41
|
|
|
MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$25,045.25
|
|
|
Service Code
|
MSDRG 757
|
| Min. Negotiated Rate |
$4,319.00 |
| Max. Negotiated Rate |
$25,045.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,319.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,463.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,319.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,886.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,732.50
|
| Rate for Payer: GEHA Medicare |
$14,732.50
|
| Rate for Payer: Humana ChoiceCare |
$16,205.75
|
| Rate for Payer: Humana Medicare Advantage |
$14,732.50
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,750.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,886.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,732.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,045.25
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,625.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,886.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,732.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,067.47
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,437.85
|
| Rate for Payer: United Healthcare Commercial |
$9,652.35
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,886.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,732.50
|
| Rate for Payer: Zelis Medicare |
$12,522.62
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,270.22
|
|
