|
MS-DRG 42.00: LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$67,641.47
|
|
|
Service Code
|
MSDRG 956
|
| Min. Negotiated Rate |
$25,036.72 |
| Max. Negotiated Rate |
$67,641.47 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$28,149.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$30,961.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$28,149.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$49,954.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$39,789.10
|
| Rate for Payer: GEHA Medicare |
$39,789.10
|
| Rate for Payer: Humana ChoiceCare |
$43,768.01
|
| Rate for Payer: Humana Medicare Advantage |
$39,789.10
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$66,845.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49,954.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$39,789.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$67,641.47
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$55,704.74
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49,954.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$39,789.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$56,898.41
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$38,993.32
|
| Rate for Payer: United Healthcare Commercial |
$26,068.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49,954.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39,789.10
|
| Rate for Payer: Zelis Medicare |
$33,820.74
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$25,036.72
|
|
|
MS-DRG 42.00: LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT
|
Facility
|
IP
|
$188,452.53
|
|
|
Service Code
|
MSDRG 005
|
| Min. Negotiated Rate |
$60,754.05 |
| Max. Negotiated Rate |
$188,452.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$60,754.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$86,260.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$60,754.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$107,513.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$110,854.43
|
| Rate for Payer: GEHA Medicare |
$110,854.43
|
| Rate for Payer: Humana ChoiceCare |
$121,939.87
|
| Rate for Payer: Humana Medicare Advantage |
$110,854.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$186,235.44
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$107,513.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$110,854.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$188,452.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$155,196.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$107,513.20
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$110,854.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$158,521.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$108,637.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$107,513.20
|
| Rate for Payer: Zelis Medicare |
$94,226.27
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$69,753.57
|
|
|
MS-DRG 42.00: LIVER TRANSPLANT WITHOUT MCC
|
Facility
|
IP
|
$85,811.80
|
|
|
Service Code
|
MSDRG 006
|
| Min. Negotiated Rate |
$28,865.55 |
| Max. Negotiated Rate |
$85,811.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$28,865.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$39,278.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$28,865.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$51,219.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$50,477.53
|
| Rate for Payer: GEHA Medicare |
$50,477.53
|
| Rate for Payer: Humana ChoiceCare |
$55,525.28
|
| Rate for Payer: Humana Medicare Advantage |
$50,477.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$84,802.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51,219.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$50,477.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$85,811.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$70,668.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51,219.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$50,477.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$72,182.87
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$49,467.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51,219.16
|
| Rate for Payer: Zelis Medicare |
$42,905.90
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$31,762.26
|
|
|
MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC
|
Facility
|
IP
|
$34,914.33
|
|
|
Service Code
|
MSDRG 496
|
| Min. Negotiated Rate |
$8,030.05 |
| Max. Negotiated Rate |
$34,914.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,030.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,981.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,030.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,437.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,537.84
|
| Rate for Payer: GEHA Medicare |
$20,537.84
|
| Rate for Payer: Humana ChoiceCare |
$22,591.62
|
| Rate for Payer: Humana Medicare Advantage |
$20,537.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,503.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,437.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,537.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,914.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,752.98
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,437.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,537.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,369.11
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,127.08
|
| Rate for Payer: United Healthcare Commercial |
$13,455.86
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,437.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,537.84
|
| Rate for Payer: Zelis Medicare |
$17,457.16
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,923.15
|
|
|
MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC
|
Facility
|
IP
|
$62,300.80
|
|
|
Service Code
|
MSDRG 495
|
| Min. Negotiated Rate |
$16,529.10 |
| Max. Negotiated Rate |
$62,300.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,529.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,516.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,529.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$29,441.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$36,647.53
|
| Rate for Payer: GEHA Medicare |
$36,647.53
|
| Rate for Payer: Humana ChoiceCare |
$40,312.28
|
| Rate for Payer: Humana Medicare Advantage |
$36,647.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$61,567.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$29,441.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$36,647.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$62,300.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$51,306.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$29,441.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$36,647.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$52,405.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$35,914.58
|
| Rate for Payer: United Healthcare Commercial |
$24,010.49
|
| Rate for Payer: United Healthcare Managed Medicaid |
$29,441.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,647.53
|
| Rate for Payer: Zelis Medicare |
$31,150.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23,059.93
|
|
|
MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$23,758.74
|
|
|
Service Code
|
MSDRG 497
|
| Min. Negotiated Rate |
$4,995.55 |
| Max. Negotiated Rate |
$23,758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,995.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,875.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,995.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,080.49
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,975.73
|
| Rate for Payer: GEHA Medicare |
$13,975.73
|
| Rate for Payer: Humana ChoiceCare |
$15,373.30
|
| Rate for Payer: Humana Medicare Advantage |
$13,975.73
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,479.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,080.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,975.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,758.74
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,566.02
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,080.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,975.73
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,985.29
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,696.22
|
| Rate for Payer: United Healthcare Commercial |
$9,156.53
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,080.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,975.73
|
| Rate for Payer: Zelis Medicare |
$11,879.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,794.03
|
|
|
MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC
|
Facility
|
IP
|
$44,680.79
|
|
|
Service Code
|
MSDRG 498
|
| Min. Negotiated Rate |
$4,416.30 |
| Max. Negotiated Rate |
$44,680.79 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,416.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,451.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,416.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,057.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,282.82
|
| Rate for Payer: GEHA Medicare |
$26,282.82
|
| Rate for Payer: Humana ChoiceCare |
$28,911.10
|
| Rate for Payer: Humana Medicare Advantage |
$26,282.82
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$44,155.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,057.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,282.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$44,680.79
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$36,795.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,057.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,282.82
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37,584.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$25,757.16
|
| Rate for Payer: United Healthcare Commercial |
$17,219.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,057.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,282.82
|
| Rate for Payer: Zelis Medicare |
$22,340.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,538.10
|
|
|
MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$20,541.59
|
|
|
Service Code
|
MSDRG 499
|
| Min. Negotiated Rate |
$3,270.75 |
| Max. Negotiated Rate |
$20,541.59 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,270.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,402.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,270.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,035.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,083.29
|
| Rate for Payer: GEHA Medicare |
$12,083.29
|
| Rate for Payer: Humana ChoiceCare |
$13,291.62
|
| Rate for Payer: Humana Medicare Advantage |
$12,083.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,299.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,035.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,083.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,541.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,916.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,035.64
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,083.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,279.10
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,841.62
|
| Rate for Payer: United Healthcare Commercial |
$7,916.66
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,035.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,083.29
|
| Rate for Payer: Zelis Medicare |
$10,270.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,603.24
|
|
|
MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC
|
Facility
|
IP
|
$42,488.25
|
|
|
Service Code
|
MSDRG 493
|
| Min. Negotiated Rate |
$6,108.55 |
| Max. Negotiated Rate |
$42,488.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,108.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,448.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,108.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,045.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,993.09
|
| Rate for Payer: GEHA Medicare |
$24,993.09
|
| Rate for Payer: Humana ChoiceCare |
$27,492.40
|
| Rate for Payer: Humana Medicare Advantage |
$24,993.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$41,988.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,045.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,993.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$42,488.25
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$34,990.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,045.32
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,993.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35,740.12
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,493.23
|
| Rate for Payer: United Healthcare Commercial |
$16,374.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,045.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,993.09
|
| Rate for Payer: Zelis Medicare |
$21,244.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,726.55
|
|
|
MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC
|
Facility
|
IP
|
$62,842.32
|
|
|
Service Code
|
MSDRG 492
|
| Min. Negotiated Rate |
$8,767.85 |
| Max. Negotiated Rate |
$62,842.32 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,767.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,764.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,767.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,739.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$36,966.07
|
| Rate for Payer: GEHA Medicare |
$36,966.07
|
| Rate for Payer: Humana ChoiceCare |
$40,662.68
|
| Rate for Payer: Humana Medicare Advantage |
$36,966.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$62,103.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,739.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$36,966.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$62,842.32
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$51,752.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,739.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$36,966.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$52,861.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$36,226.75
|
| Rate for Payer: United Healthcare Commercial |
$24,219.18
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,739.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,966.07
|
| Rate for Payer: Zelis Medicare |
$31,421.16
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23,260.36
|
|
|
MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$33,364.17
|
|
|
Service Code
|
MSDRG 494
|
| Min. Negotiated Rate |
$5,159.00 |
| Max. Negotiated Rate |
$33,364.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,159.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,271.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,159.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,369.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,625.98
|
| Rate for Payer: GEHA Medicare |
$19,625.98
|
| Rate for Payer: Humana ChoiceCare |
$21,588.58
|
| Rate for Payer: Humana Medicare Advantage |
$19,625.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,971.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,369.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,625.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$33,364.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,476.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,369.04
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,625.98
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,065.15
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,233.46
|
| Rate for Payer: United Healthcare Commercial |
$12,858.43
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,369.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,625.98
|
| Rate for Payer: Zelis Medicare |
$16,682.08
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,349.37
|
|
|
MS-DRG 42.00: LUNG TRANSPLANT
|
Facility
|
IP
|
$231,266.40
|
|
|
Service Code
|
MSDRG 007
|
| Min. Negotiated Rate |
$55,727.35 |
| Max. Negotiated Rate |
$231,266.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$55,727.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$105,857.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$55,727.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$98,639.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$136,039.06
|
| Rate for Payer: GEHA Medicare |
$136,039.06
|
| Rate for Payer: Humana ChoiceCare |
$149,642.97
|
| Rate for Payer: Humana Medicare Advantage |
$136,039.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$228,545.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$98,639.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$136,039.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$231,266.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$190,454.68
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$98,639.37
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$136,039.06
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$194,535.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$133,318.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$98,639.37
|
| Rate for Payer: Zelis Medicare |
$115,633.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$85,600.64
|
|
|
MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$39,504.72
|
|
|
Service Code
|
MSDRG 821
|
| Min. Negotiated Rate |
$10,421.25 |
| Max. Negotiated Rate |
$39,504.72 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,421.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,082.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,421.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,658.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,238.07
|
| Rate for Payer: GEHA Medicare |
$23,238.07
|
| Rate for Payer: Humana ChoiceCare |
$25,561.88
|
| Rate for Payer: Humana Medicare Advantage |
$23,238.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,039.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,658.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,238.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39,504.72
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,533.30
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,658.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,238.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,230.44
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,773.31
|
| Rate for Payer: United Healthcare Commercial |
$15,224.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,658.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,238.07
|
| Rate for Payer: Zelis Medicare |
$19,752.36
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,622.22
|
|
|
MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$103,031.83
|
|
|
Service Code
|
MSDRG 820
|
| Min. Negotiated Rate |
$25,173.05 |
| Max. Negotiated Rate |
$103,031.83 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$25,173.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$47,160.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$25,173.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$44,700.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$60,606.96
|
| Rate for Payer: GEHA Medicare |
$60,606.96
|
| Rate for Payer: Humana ChoiceCare |
$66,667.66
|
| Rate for Payer: Humana Medicare Advantage |
$60,606.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$101,819.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$44,700.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$60,606.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$103,031.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$84,849.74
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$44,700.64
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$60,606.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$86,667.95
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$59,394.82
|
| Rate for Payer: United Healthcare Commercial |
$39,708.09
|
| Rate for Payer: United Healthcare Managed Medicaid |
$44,700.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60,606.96
|
| Rate for Payer: Zelis Medicare |
$51,515.92
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$38,136.07
|
|
|
MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,238.99
|
|
|
Service Code
|
MSDRG 822
|
| Min. Negotiated Rate |
$5,530.35 |
| Max. Negotiated Rate |
$20,238.99 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,530.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,263.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,530.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,024.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,905.29
|
| Rate for Payer: GEHA Medicare |
$11,905.29
|
| Rate for Payer: Humana ChoiceCare |
$13,095.82
|
| Rate for Payer: Humana Medicare Advantage |
$11,905.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,000.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,024.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,905.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,238.99
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,667.41
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,024.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,905.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,024.56
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,667.18
|
| Rate for Payer: United Healthcare Commercial |
$7,800.03
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,024.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,905.29
|
| Rate for Payer: Zelis Medicare |
$10,119.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,491.23
|
|
|
MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC
|
Facility
|
IP
|
$27,747.45
|
|
|
Service Code
|
MSDRG 841
|
| Min. Negotiated Rate |
$10,270.40 |
| Max. Negotiated Rate |
$27,747.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,511.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,700.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,511.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,818.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,322.03
|
| Rate for Payer: GEHA Medicare |
$16,322.03
|
| Rate for Payer: Humana ChoiceCare |
$17,954.23
|
| Rate for Payer: Humana Medicare Advantage |
$16,322.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,421.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,818.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,322.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,747.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,850.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,818.73
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,322.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,340.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,995.59
|
| Rate for Payer: United Healthcare Commercial |
$10,693.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,818.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,322.03
|
| Rate for Payer: Zelis Medicare |
$13,873.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,270.40
|
|
|
MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC
|
Facility
|
IP
|
$56,432.78
|
|
|
Service Code
|
MSDRG 840
|
| Min. Negotiated Rate |
$14,285.95 |
| Max. Negotiated Rate |
$56,432.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,285.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,830.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,285.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25,481.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$33,195.75
|
| Rate for Payer: GEHA Medicare |
$33,195.75
|
| Rate for Payer: Humana ChoiceCare |
$36,515.32
|
| Rate for Payer: Humana Medicare Advantage |
$33,195.75
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$55,768.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25,481.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$33,195.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$56,432.78
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$46,474.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25,481.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$33,195.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$47,469.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$32,531.83
|
| Rate for Payer: United Healthcare Commercial |
$21,748.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25,481.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,195.75
|
| Rate for Payer: Zelis Medicare |
$28,216.39
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,887.95
|
|
|
MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC
|
Facility
|
IP
|
$38,920.75
|
|
|
Service Code
|
MSDRG 824
|
| Min. Negotiated Rate |
$10,270.05 |
| Max. Negotiated Rate |
$38,920.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,270.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,815.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,270.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,391.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,894.56
|
| Rate for Payer: GEHA Medicare |
$22,894.56
|
| Rate for Payer: Humana ChoiceCare |
$25,184.02
|
| Rate for Payer: Humana Medicare Advantage |
$22,894.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$38,462.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,391.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,894.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$38,920.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,052.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,391.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,894.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$32,739.22
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,436.67
|
| Rate for Payer: United Healthcare Commercial |
$14,999.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,391.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,894.56
|
| Rate for Payer: Zelis Medicare |
$19,460.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,406.07
|
|
|
MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC
|
Facility
|
IP
|
$82,808.75
|
|
|
Service Code
|
MSDRG 823
|
| Min. Negotiated Rate |
$19,989.20 |
| Max. Negotiated Rate |
$82,808.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$19,989.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$37,903.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$19,989.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$35,549.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$48,711.03
|
| Rate for Payer: GEHA Medicare |
$48,711.03
|
| Rate for Payer: Humana ChoiceCare |
$53,582.13
|
| Rate for Payer: Humana Medicare Advantage |
$48,711.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$81,834.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$35,549.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$48,711.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$82,808.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$68,195.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$35,549.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$48,711.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$69,656.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$47,736.81
|
| Rate for Payer: United Healthcare Commercial |
$31,914.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$35,549.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48,711.03
|
| Rate for Payer: Zelis Medicare |
$41,404.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$30,650.72
|
|
|
MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$21,780.33
|
|
|
Service Code
|
MSDRG 825
|
| Min. Negotiated Rate |
$5,926.20 |
| Max. Negotiated Rate |
$21,780.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,926.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,969.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,926.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,723.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,811.96
|
| Rate for Payer: GEHA Medicare |
$12,811.96
|
| Rate for Payer: Humana ChoiceCare |
$14,093.16
|
| Rate for Payer: Humana Medicare Advantage |
$12,811.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,524.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,723.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,811.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,780.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,936.74
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,723.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,811.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,321.10
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,555.72
|
| Rate for Payer: United Healthcare Commercial |
$8,394.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,723.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,811.96
|
| Rate for Payer: Zelis Medicare |
$10,890.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,061.74
|
|
|
MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC
|
Facility
|
IP
|
$18,614.51
|
|
|
Service Code
|
MSDRG 842
|
| Min. Negotiated Rate |
$6,889.94 |
| Max. Negotiated Rate |
$18,614.51 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,583.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,520.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,583.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,648.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,949.71
|
| Rate for Payer: GEHA Medicare |
$10,949.71
|
| Rate for Payer: Humana ChoiceCare |
$12,044.68
|
| Rate for Payer: Humana Medicare Advantage |
$10,949.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,395.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,648.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,949.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,614.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,329.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,648.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,949.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,658.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,730.72
|
| Rate for Payer: United Healthcare Commercial |
$7,173.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,648.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,949.71
|
| Rate for Payer: Zelis Medicare |
$9,307.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,889.94
|
|
|
MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITH CC
|
Facility
|
IP
|
$49,940.08
|
|
|
Service Code
|
MSDRG 654
|
| Min. Negotiated Rate |
$13,331.50 |
| Max. Negotiated Rate |
$49,940.08 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$13,331.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$22,859.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$13,331.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23,796.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29,376.52
|
| Rate for Payer: GEHA Medicare |
$29,376.52
|
| Rate for Payer: Humana ChoiceCare |
$32,314.17
|
| Rate for Payer: Humana Medicare Advantage |
$29,376.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49,352.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23,796.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29,376.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49,940.08
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$41,127.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23,796.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29,376.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$42,008.42
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28,788.99
|
| Rate for Payer: United Healthcare Commercial |
$19,246.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23,796.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,376.52
|
| Rate for Payer: Zelis Medicare |
$24,970.04
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18,484.76
|
|
|
MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITH MCC
|
Facility
|
IP
|
$98,648.48
|
|
|
Service Code
|
MSDRG 653
|
| Min. Negotiated Rate |
$23,151.45 |
| Max. Negotiated Rate |
$98,648.48 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$23,151.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$45,154.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$23,151.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41,131.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$58,028.52
|
| Rate for Payer: GEHA Medicare |
$58,028.52
|
| Rate for Payer: Humana ChoiceCare |
$63,831.37
|
| Rate for Payer: Humana Medicare Advantage |
$58,028.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$97,487.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$41,131.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$58,028.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$98,648.48
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$81,239.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$41,131.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$58,028.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$82,980.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$56,867.95
|
| Rate for Payer: United Healthcare Commercial |
$38,018.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$41,131.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$58,028.52
|
| Rate for Payer: Zelis Medicare |
$49,324.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$36,513.63
|
|
|
MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$36,760.09
|
|
|
Service Code
|
MSDRG 655
|
| Min. Negotiated Rate |
$9,704.80 |
| Max. Negotiated Rate |
$36,760.09 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,704.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,826.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,704.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,393.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,623.58
|
| Rate for Payer: GEHA Medicare |
$21,623.58
|
| Rate for Payer: Humana ChoiceCare |
$23,785.94
|
| Rate for Payer: Humana Medicare Advantage |
$21,623.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,327.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,393.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,623.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$36,760.09
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,273.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,393.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,623.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$30,921.72
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,191.11
|
| Rate for Payer: United Healthcare Commercial |
$14,167.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,393.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,623.58
|
| Rate for Payer: Zelis Medicare |
$18,380.04
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,606.32
|
|
|
MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH CC
|
Facility
|
IP
|
$44,541.02
|
|
|
Service Code
|
MSDRG 164
|
| Min. Negotiated Rate |
$14,808.50 |
| Max. Negotiated Rate |
$44,541.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,808.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,387.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,808.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26,403.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,200.60
|
| Rate for Payer: GEHA Medicare |
$26,200.60
|
| Rate for Payer: Humana ChoiceCare |
$28,820.66
|
| Rate for Payer: Humana Medicare Advantage |
$26,200.60
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$44,017.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26,403.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,200.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$44,541.02
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$36,680.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26,403.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,200.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37,466.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$25,676.59
|
| Rate for Payer: United Healthcare Commercial |
$17,165.94
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26,403.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,200.60
|
| Rate for Payer: Zelis Medicare |
$22,270.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,486.35
|
|
