|
MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC
|
Facility
|
IP
|
$24,859.42
|
|
|
Service Code
|
MSDRG 063
|
| Min. Negotiated Rate |
$9,201.44 |
| Max. Negotiated Rate |
$24,859.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,348.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,378.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,348.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,623.19
|
| Rate for Payer: GEHA Medicare |
$14,623.19
|
| Rate for Payer: Humana ChoiceCare |
$16,085.51
|
| Rate for Payer: Humana Medicare Advantage |
$14,623.19
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,566.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,764.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,623.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,859.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,472.47
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,764.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,623.19
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,911.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,330.73
|
| Rate for Payer: United Healthcare Commercial |
$9,580.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,764.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,623.19
|
| Rate for Payer: Zelis Medicare |
$12,429.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,201.44
|
|
|
MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC
|
Facility
|
IP
|
$32,350.17
|
|
|
Service Code
|
MSDRG 657
|
| Min. Negotiated Rate |
$9,967.30 |
| Max. Negotiated Rate |
$32,350.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,967.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,807.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,967.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,857.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,029.51
|
| Rate for Payer: GEHA Medicare |
$19,029.51
|
| Rate for Payer: Humana ChoiceCare |
$20,932.46
|
| Rate for Payer: Humana Medicare Advantage |
$19,029.51
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,969.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,857.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,029.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,350.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,641.31
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,857.32
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,029.51
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,212.20
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,648.92
|
| Rate for Payer: United Healthcare Commercial |
$12,467.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,857.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,029.51
|
| Rate for Payer: Zelis Medicare |
$16,175.08
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,974.06
|
|
|
MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC
|
Facility
|
IP
|
$57,653.80
|
|
|
Service Code
|
MSDRG 656
|
| Min. Negotiated Rate |
$16,310.70 |
| Max. Negotiated Rate |
$57,653.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,310.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$26,389.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,310.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$29,055.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$33,914.00
|
| Rate for Payer: GEHA Medicare |
$33,914.00
|
| Rate for Payer: Humana ChoiceCare |
$37,305.40
|
| Rate for Payer: Humana Medicare Advantage |
$33,914.00
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$56,975.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$29,055.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$33,914.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$57,653.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$47,479.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$29,055.58
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$33,914.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$48,497.02
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$33,235.72
|
| Rate for Payer: United Healthcare Commercial |
$22,219.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$29,055.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,914.00
|
| Rate for Payer: Zelis Medicare |
$28,826.90
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21,339.90
|
|
|
MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$26,614.89
|
|
|
Service Code
|
MSDRG 658
|
| Min. Negotiated Rate |
$7,970.20 |
| Max. Negotiated Rate |
$26,614.89 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,970.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,182.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,970.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,331.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,655.82
|
| Rate for Payer: GEHA Medicare |
$15,655.82
|
| Rate for Payer: Humana ChoiceCare |
$17,221.40
|
| Rate for Payer: Humana Medicare Advantage |
$15,655.82
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,301.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,331.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,655.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,614.89
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,918.15
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,331.76
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,655.82
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,387.82
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,342.70
|
| Rate for Payer: United Healthcare Commercial |
$10,257.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,331.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,655.82
|
| Rate for Payer: Zelis Medicare |
$13,307.45
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,851.20
|
|
|
MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC
|
Facility
|
IP
|
$23,712.72
|
|
|
Service Code
|
MSDRG 660
|
| Min. Negotiated Rate |
$8,431.50 |
| Max. Negotiated Rate |
$23,712.72 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,431.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,854.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,431.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,146.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,948.66
|
| Rate for Payer: GEHA Medicare |
$13,948.66
|
| Rate for Payer: Humana ChoiceCare |
$15,343.53
|
| Rate for Payer: Humana Medicare Advantage |
$13,948.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,433.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,146.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,948.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,712.72
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,528.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,146.11
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,948.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,946.58
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,669.69
|
| Rate for Payer: United Healthcare Commercial |
$9,138.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,146.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,948.66
|
| Rate for Payer: Zelis Medicare |
$11,856.36
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,777.00
|
|
|
MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
|
Facility
|
IP
|
$45,731.96
|
|
|
Service Code
|
MSDRG 659
|
| Min. Negotiated Rate |
$12,458.95 |
| Max. Negotiated Rate |
$45,731.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,458.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,932.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,458.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22,255.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,901.15
|
| Rate for Payer: GEHA Medicare |
$26,901.15
|
| Rate for Payer: Humana ChoiceCare |
$29,591.26
|
| Rate for Payer: Humana Medicare Advantage |
$26,901.15
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$45,193.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22,255.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,901.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$45,731.96
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$37,661.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22,255.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,901.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$38,468.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$26,363.13
|
| Rate for Payer: United Healthcare Commercial |
$17,624.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22,255.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,901.15
|
| Rate for Payer: Zelis Medicare |
$22,865.98
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,927.17
|
|
|
MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$18,166.78
|
|
|
Service Code
|
MSDRG 661
|
| Min. Negotiated Rate |
$5,982.90 |
| Max. Negotiated Rate |
$18,166.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,982.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,315.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,982.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,823.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,686.34
|
| Rate for Payer: GEHA Medicare |
$10,686.34
|
| Rate for Payer: Humana ChoiceCare |
$11,754.97
|
| Rate for Payer: Humana Medicare Advantage |
$10,686.34
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,953.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,823.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,686.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,166.78
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,960.88
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,823.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,686.34
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,281.47
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,472.61
|
| Rate for Payer: United Healthcare Commercial |
$7,001.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,823.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,686.34
|
| Rate for Payer: Zelis Medicare |
$9,083.39
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,724.23
|
|
|
MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC
|
Facility
|
IP
|
$20,709.71
|
|
|
Service Code
|
MSDRG 689
|
| Min. Negotiated Rate |
$5,412.75 |
| Max. Negotiated Rate |
$20,709.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,412.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,479.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,412.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,816.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,182.18
|
| Rate for Payer: GEHA Medicare |
$12,182.18
|
| Rate for Payer: Humana ChoiceCare |
$13,400.40
|
| Rate for Payer: Humana Medicare Advantage |
$12,182.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,466.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,816.99
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,182.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,709.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,055.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,816.99
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,182.18
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,420.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,938.54
|
| Rate for Payer: United Healthcare Commercial |
$7,981.45
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,816.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,182.18
|
| Rate for Payer: Zelis Medicare |
$10,354.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,665.47
|
|
|
MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC
|
Facility
|
IP
|
$14,723.00
|
|
|
Service Code
|
MSDRG 690
|
| Min. Negotiated Rate |
$3,127.60 |
| Max. Negotiated Rate |
$14,723.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,127.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,501.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,127.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,782.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,660.59
|
| Rate for Payer: GEHA Medicare |
$8,660.59
|
| Rate for Payer: Humana ChoiceCare |
$9,526.65
|
| Rate for Payer: Humana Medicare Advantage |
$8,660.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,549.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,782.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,660.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,723.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,124.83
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,782.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,660.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,384.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,487.38
|
| Rate for Payer: United Healthcare Commercial |
$5,473.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,782.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,660.59
|
| Rate for Payer: Zelis Medicare |
$7,361.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,257.03
|
|
|
MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC
|
Facility
|
IP
|
$18,628.63
|
|
|
Service Code
|
MSDRG 687
|
| Min. Negotiated Rate |
$6,895.19 |
| Max. Negotiated Rate |
$18,628.63 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,928.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,526.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,928.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,258.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,958.02
|
| Rate for Payer: GEHA Medicare |
$10,958.02
|
| Rate for Payer: Humana ChoiceCare |
$12,053.82
|
| Rate for Payer: Humana Medicare Advantage |
$10,958.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,409.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,258.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,958.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,628.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,341.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,258.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,958.02
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,669.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,738.86
|
| Rate for Payer: United Healthcare Commercial |
$7,179.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,258.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,958.02
|
| Rate for Payer: Zelis Medicare |
$9,314.32
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,895.19
|
|
|
MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC
|
Facility
|
IP
|
$33,369.45
|
|
|
Service Code
|
MSDRG 686
|
| Min. Negotiated Rate |
$11,481.75 |
| Max. Negotiated Rate |
$33,369.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,481.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,274.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,481.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,530.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,629.09
|
| Rate for Payer: GEHA Medicare |
$19,629.09
|
| Rate for Payer: Humana ChoiceCare |
$21,592.00
|
| Rate for Payer: Humana Medicare Advantage |
$19,629.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,976.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,530.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,629.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$33,369.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,480.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,530.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,629.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,069.60
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,236.51
|
| Rate for Payer: United Healthcare Commercial |
$12,860.47
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,530.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,629.09
|
| Rate for Payer: Zelis Medicare |
$16,684.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,351.33
|
|
|
MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,577.80
|
|
|
Service Code
|
MSDRG 688
|
| Min. Negotiated Rate |
$4,743.51 |
| Max. Negotiated Rate |
$13,577.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,173.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,866.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,173.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,160.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,986.94
|
| Rate for Payer: GEHA Medicare |
$7,986.94
|
| Rate for Payer: Humana ChoiceCare |
$8,785.63
|
| Rate for Payer: Humana Medicare Advantage |
$7,986.94
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,418.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,160.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,986.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,577.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,181.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,160.24
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,986.94
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,421.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,827.20
|
| Rate for Payer: United Healthcare Commercial |
$4,939.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,160.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,986.94
|
| Rate for Payer: Zelis Medicare |
$6,788.90
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,743.51
|
|
|
MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$19,957.64
|
|
|
Service Code
|
MSDRG 695
|
| Min. Negotiated Rate |
$4,476.85 |
| Max. Negotiated Rate |
$19,957.64 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,476.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,135.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,476.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,164.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,739.79
|
| Rate for Payer: GEHA Medicare |
$11,739.79
|
| Rate for Payer: Humana ChoiceCare |
$12,913.77
|
| Rate for Payer: Humana Medicare Advantage |
$11,739.79
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,722.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,164.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,739.79
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,957.64
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,435.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,164.81
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,739.79
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,787.90
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,504.99
|
| Rate for Payer: United Healthcare Commercial |
$7,691.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,164.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,739.79
|
| Rate for Payer: Zelis Medicare |
$9,978.82
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,387.09
|
|
|
MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$13,104.50
|
|
|
Service Code
|
MSDRG 696
|
| Min. Negotiated Rate |
$2,689.05 |
| Max. Negotiated Rate |
$13,104.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,689.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,603.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,689.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,008.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,708.53
|
| Rate for Payer: GEHA Medicare |
$7,708.53
|
| Rate for Payer: Humana ChoiceCare |
$8,479.38
|
| Rate for Payer: Humana Medicare Advantage |
$7,708.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,950.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,008.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,708.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,104.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,791.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,008.74
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,708.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,023.20
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,554.36
|
| Rate for Payer: United Healthcare Commercial |
$4,718.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,008.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,708.53
|
| Rate for Payer: Zelis Medicare |
$6,552.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,531.29
|
|
|
MS-DRG 42.00: KIDNEY TRANSPLANT
|
Facility
|
IP
|
$82,971.45
|
|
|
Service Code
|
MSDRG 652
|
| Min. Negotiated Rate |
$20,117.67 |
| Max. Negotiated Rate |
$82,971.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$46,852.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$24,878.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$46,852.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$82,971.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$31,971.59
|
| Rate for Payer: GEHA Medicare |
$31,971.59
|
| Rate for Payer: Humana ChoiceCare |
$35,168.75
|
| Rate for Payer: Humana Medicare Advantage |
$31,971.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$53,712.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$82,971.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$31,971.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$54,351.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$44,760.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$82,971.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$31,971.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$45,719.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$31,332.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$82,971.45
|
| Rate for Payer: Zelis Medicare |
$27,175.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,117.67
|
|
|
MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC
|
Facility
|
IP
|
$86,359.22
|
|
|
Service Code
|
MSDRG 650
|
| Min. Negotiated Rate |
$30,177.81 |
| Max. Negotiated Rate |
$86,359.22 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$48,771.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$37,319.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$48,771.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$86,359.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$47,959.49
|
| Rate for Payer: GEHA Medicare |
$47,959.49
|
| Rate for Payer: Humana ChoiceCare |
$52,755.44
|
| Rate for Payer: Humana Medicare Advantage |
$47,959.49
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$80,571.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$86,359.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$47,959.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$81,531.13
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$67,143.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$86,359.22
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$47,959.49
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$68,582.07
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$47,000.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$86,359.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$47,959.49
|
| Rate for Payer: Zelis Medicare |
$40,765.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$30,177.81
|
|
|
MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC
|
Facility
|
IP
|
$66,107.33
|
|
|
Service Code
|
MSDRG 651
|
| Min. Negotiated Rate |
$22,744.88 |
| Max. Negotiated Rate |
$66,107.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$37,299.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,127.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$37,299.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$66,107.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$36,146.81
|
| Rate for Payer: GEHA Medicare |
$36,146.81
|
| Rate for Payer: Humana ChoiceCare |
$39,761.49
|
| Rate for Payer: Humana Medicare Advantage |
$36,146.81
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$60,726.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$66,107.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$36,146.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$61,449.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$50,605.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$66,107.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$36,146.81
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$51,689.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$35,423.87
|
| Rate for Payer: United Healthcare Managed Medicaid |
$66,107.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,146.81
|
| Rate for Payer: Zelis Medicare |
$30,724.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,744.88
|
|
|
MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC
|
Facility
|
IP
|
$34,779.86
|
|
|
Service Code
|
MSDRG 488
|
| Min. Negotiated Rate |
$7,449.40 |
| Max. Negotiated Rate |
$34,779.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,449.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,919.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,449.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,412.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,458.74
|
| Rate for Payer: GEHA Medicare |
$20,458.74
|
| Rate for Payer: Humana ChoiceCare |
$22,504.61
|
| Rate for Payer: Humana Medicare Advantage |
$20,458.74
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,370.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,412.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,458.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,779.86
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,642.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,412.37
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,458.74
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,256.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,049.57
|
| Rate for Payer: United Healthcare Commercial |
$13,404.03
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,412.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,458.74
|
| Rate for Payer: Zelis Medicare |
$17,389.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,873.37
|
|
|
MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$21,914.80
|
|
|
Service Code
|
MSDRG 489
|
| Min. Negotiated Rate |
$5,361.30 |
| Max. Negotiated Rate |
$21,914.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,361.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,031.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,361.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,726.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,891.06
|
| Rate for Payer: GEHA Medicare |
$12,891.06
|
| Rate for Payer: Humana ChoiceCare |
$14,180.17
|
| Rate for Payer: Humana Medicare Advantage |
$12,891.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,656.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,726.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,891.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,914.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,047.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,726.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,891.06
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,434.22
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,633.24
|
| Rate for Payer: United Healthcare Commercial |
$8,445.89
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,726.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,891.06
|
| Rate for Payer: Zelis Medicare |
$10,957.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,111.52
|
|
|
MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC
|
Facility
|
IP
|
$37,531.58
|
|
|
Service Code
|
MSDRG 486
|
| Min. Negotiated Rate |
$9,458.40 |
| Max. Negotiated Rate |
$37,531.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,458.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,179.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,458.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,958.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,077.40
|
| Rate for Payer: GEHA Medicare |
$22,077.40
|
| Rate for Payer: Humana ChoiceCare |
$24,285.14
|
| Rate for Payer: Humana Medicare Advantage |
$22,077.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,090.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,958.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,077.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,531.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,908.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,958.94
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,077.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,570.68
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,635.85
|
| Rate for Payer: United Healthcare Commercial |
$14,464.54
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,958.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,077.40
|
| Rate for Payer: Zelis Medicare |
$18,765.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,891.90
|
|
|
MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC
|
Facility
|
IP
|
$56,968.96
|
|
|
Service Code
|
MSDRG 485
|
| Min. Negotiated Rate |
$15,794.80 |
| Max. Negotiated Rate |
$56,968.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15,794.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$26,076.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15,794.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$28,144.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$33,511.15
|
| Rate for Payer: GEHA Medicare |
$33,511.15
|
| Rate for Payer: Humana ChoiceCare |
$36,862.26
|
| Rate for Payer: Humana Medicare Advantage |
$33,511.15
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$56,298.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$28,144.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$33,511.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$56,968.96
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$46,915.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$28,144.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$33,511.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$47,920.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$32,840.93
|
| Rate for Payer: United Healthcare Commercial |
$21,955.63
|
| Rate for Payer: United Healthcare Managed Medicaid |
$28,144.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,511.15
|
| Rate for Payer: Zelis Medicare |
$28,484.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21,086.42
|
|
|
MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$27,963.35
|
|
|
Service Code
|
MSDRG 487
|
| Min. Negotiated Rate |
$6,357.40 |
| Max. Negotiated Rate |
$27,963.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,357.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,799.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,357.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,484.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,449.03
|
| Rate for Payer: GEHA Medicare |
$16,449.03
|
| Rate for Payer: Humana ChoiceCare |
$18,093.93
|
| Rate for Payer: Humana Medicare Advantage |
$16,449.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,634.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,484.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,449.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,963.35
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,028.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,484.62
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,449.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,522.11
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,120.05
|
| Rate for Payer: United Healthcare Commercial |
$10,776.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,484.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,449.03
|
| Rate for Payer: Zelis Medicare |
$13,981.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,350.31
|
|
|
MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$29,347.17
|
|
|
Service Code
|
MSDRG 418
|
| Min. Negotiated Rate |
$5,786.90 |
| Max. Negotiated Rate |
$29,347.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,786.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,433.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,786.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,477.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,263.04
|
| Rate for Payer: GEHA Medicare |
$17,263.04
|
| Rate for Payer: Humana ChoiceCare |
$18,989.34
|
| Rate for Payer: Humana Medicare Advantage |
$17,263.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,001.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,477.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,263.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,347.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,168.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,477.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,263.04
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,686.15
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,917.78
|
| Rate for Payer: United Healthcare Commercial |
$11,310.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,477.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,263.04
|
| Rate for Payer: Zelis Medicare |
$14,673.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,862.52
|
|
|
MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$42,054.70
|
|
|
Service Code
|
MSDRG 417
|
| Min. Negotiated Rate |
$7,664.65 |
| Max. Negotiated Rate |
$42,054.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,664.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,249.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,664.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,792.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,738.06
|
| Rate for Payer: GEHA Medicare |
$24,738.06
|
| Rate for Payer: Humana ChoiceCare |
$27,211.87
|
| Rate for Payer: Humana Medicare Advantage |
$24,738.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$41,559.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,792.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,738.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$42,054.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$34,633.28
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,792.36
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,738.06
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35,375.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,243.30
|
| Rate for Payer: United Healthcare Commercial |
$16,207.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,792.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,738.06
|
| Rate for Payer: Zelis Medicare |
$21,027.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,566.08
|
|
|
MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$23,316.35
|
|
|
Service Code
|
MSDRG 419
|
| Min. Negotiated Rate |
$5,227.25 |
| Max. Negotiated Rate |
$23,316.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,227.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,672.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,227.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,489.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,715.50
|
| Rate for Payer: GEHA Medicare |
$13,715.50
|
| Rate for Payer: Humana ChoiceCare |
$15,087.05
|
| Rate for Payer: Humana Medicare Advantage |
$13,715.50
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,042.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,489.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,715.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,316.35
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,201.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,489.52
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,715.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,613.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,441.19
|
| Rate for Payer: United Healthcare Commercial |
$8,986.03
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,489.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,715.50
|
| Rate for Payer: Zelis Medicare |
$11,658.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,630.28
|
|
