|
MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH MCC
|
Facility
|
IP
|
$81,564.71
|
|
|
Service Code
|
MSDRG 163
|
| Min. Negotiated Rate |
$28,113.40 |
| Max. Negotiated Rate |
$81,564.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$28,113.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$37,334.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$28,113.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$49,891.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$47,979.24
|
| Rate for Payer: GEHA Medicare |
$47,979.24
|
| Rate for Payer: Humana ChoiceCare |
$52,777.16
|
| Rate for Payer: Humana Medicare Advantage |
$47,979.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$80,605.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49,891.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$47,979.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$81,564.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$67,170.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49,891.36
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$47,979.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$68,610.31
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$47,019.66
|
| Rate for Payer: United Healthcare Commercial |
$31,434.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49,891.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$47,979.24
|
| Rate for Payer: Zelis Medicare |
$40,782.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$30,190.26
|
|
|
MS-DRG 42.00: MAJOR CHEST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$32,985.49
|
|
|
Service Code
|
MSDRG 165
|
| Min. Negotiated Rate |
$10,932.60 |
| Max. Negotiated Rate |
$32,985.49 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,932.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,098.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,932.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,561.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,403.23
|
| Rate for Payer: GEHA Medicare |
$19,403.23
|
| Rate for Payer: Humana ChoiceCare |
$21,343.55
|
| Rate for Payer: Humana Medicare Advantage |
$19,403.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,597.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,561.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,403.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,985.49
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,164.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,561.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,403.23
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,746.62
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,015.17
|
| Rate for Payer: United Healthcare Commercial |
$12,712.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,561.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,403.23
|
| Rate for Payer: Zelis Medicare |
$16,492.75
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,209.20
|
|
|
MS-DRG 42.00: MAJOR CHEST TRAUMA WITH CC
|
Facility
|
IP
|
$18,901.18
|
|
|
Service Code
|
MSDRG 184
|
| Min. Negotiated Rate |
$4,412.45 |
| Max. Negotiated Rate |
$18,901.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,412.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,651.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,412.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,051.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,118.34
|
| Rate for Payer: GEHA Medicare |
$11,118.34
|
| Rate for Payer: Humana ChoiceCare |
$12,230.17
|
| Rate for Payer: Humana Medicare Advantage |
$11,118.34
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,678.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,051.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,118.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,901.18
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,565.68
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,051.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,118.34
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,899.23
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,895.97
|
| Rate for Payer: United Healthcare Commercial |
$7,284.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,051.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,118.34
|
| Rate for Payer: Zelis Medicare |
$9,450.59
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,996.06
|
|
|
MS-DRG 42.00: MAJOR CHEST TRAUMA WITH MCC
|
Facility
|
IP
|
$28,088.98
|
|
|
Service Code
|
MSDRG 183
|
| Min. Negotiated Rate |
$6,909.00 |
| Max. Negotiated Rate |
$28,088.98 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,909.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,857.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,909.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,458.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,522.93
|
| Rate for Payer: GEHA Medicare |
$16,522.93
|
| Rate for Payer: Humana ChoiceCare |
$18,175.22
|
| Rate for Payer: Humana Medicare Advantage |
$16,522.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,758.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,458.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,522.93
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,088.98
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,132.10
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,458.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,522.93
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,627.79
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,192.47
|
| Rate for Payer: United Healthcare Commercial |
$10,825.39
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,458.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,522.93
|
| Rate for Payer: Zelis Medicare |
$14,044.49
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,396.82
|
|
|
MS-DRG 42.00: MAJOR CHEST TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$14,359.29
|
|
|
Service Code
|
MSDRG 185
|
| Min. Negotiated Rate |
$3,910.55 |
| Max. Negotiated Rate |
$14,359.29 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,910.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,299.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,910.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,165.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,446.64
|
| Rate for Payer: GEHA Medicare |
$8,446.64
|
| Rate for Payer: Humana ChoiceCare |
$9,291.30
|
| Rate for Payer: Humana Medicare Advantage |
$8,446.64
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,190.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,165.10
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,446.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,359.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,825.30
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,165.10
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,446.64
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,078.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,277.71
|
| Rate for Payer: United Healthcare Commercial |
$5,303.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,165.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,446.64
|
| Rate for Payer: Zelis Medicare |
$7,179.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,093.94
|
|
|
MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH CC
|
Facility
|
IP
|
$18,007.51
|
|
|
Service Code
|
MSDRG 369
|
| Min. Negotiated Rate |
$3,884.65 |
| Max. Negotiated Rate |
$18,007.51 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,884.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,242.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,884.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,119.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,592.65
|
| Rate for Payer: GEHA Medicare |
$10,592.65
|
| Rate for Payer: Humana ChoiceCare |
$11,651.92
|
| Rate for Payer: Humana Medicare Advantage |
$10,592.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,795.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,592.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,007.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,829.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,592.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,147.49
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,380.80
|
| Rate for Payer: United Healthcare Commercial |
$6,940.03
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,592.65
|
| Rate for Payer: Zelis Medicare |
$9,003.75
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,665.28
|
|
|
MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH MCC
|
Facility
|
IP
|
$29,552.43
|
|
|
Service Code
|
MSDRG 368
|
| Min. Negotiated Rate |
$5,515.30 |
| Max. Negotiated Rate |
$29,552.43 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,515.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,527.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,515.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,998.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,383.78
|
| Rate for Payer: GEHA Medicare |
$17,383.78
|
| Rate for Payer: Humana ChoiceCare |
$19,122.16
|
| Rate for Payer: Humana Medicare Advantage |
$17,383.78
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,204.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,998.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,383.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,552.43
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,337.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,998.03
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,383.78
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,858.81
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,036.10
|
| Rate for Payer: United Healthcare Commercial |
$11,389.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,998.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,383.78
|
| Rate for Payer: Zelis Medicare |
$14,776.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,938.50
|
|
|
MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,195.06
|
|
|
Service Code
|
MSDRG 370
|
| Min. Negotiated Rate |
$3,054.80 |
| Max. Negotiated Rate |
$13,195.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,054.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,653.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,054.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,654.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,761.80
|
| Rate for Payer: GEHA Medicare |
$7,761.80
|
| Rate for Payer: Humana ChoiceCare |
$8,537.98
|
| Rate for Payer: Humana Medicare Advantage |
$7,761.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,039.82
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,654.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,761.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,195.06
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,866.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,654.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,761.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,099.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,606.56
|
| Rate for Payer: United Healthcare Commercial |
$4,760.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,654.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,761.80
|
| Rate for Payer: Zelis Medicare |
$6,597.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,571.90
|
|
|
MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC
|
Facility
|
IP
|
$18,214.58
|
|
|
Service Code
|
MSDRG 372
|
| Min. Negotiated Rate |
$4,631.20 |
| Max. Negotiated Rate |
$18,214.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,631.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,337.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,631.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,437.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,714.46
|
| Rate for Payer: GEHA Medicare |
$10,714.46
|
| Rate for Payer: Humana ChoiceCare |
$11,785.91
|
| Rate for Payer: Humana Medicare Advantage |
$10,714.46
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,000.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,437.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,714.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,214.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,000.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,437.29
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,714.46
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,321.68
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,500.17
|
| Rate for Payer: United Healthcare Commercial |
$7,019.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,437.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,714.46
|
| Rate for Payer: Zelis Medicare |
$9,107.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,741.91
|
|
|
MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC
|
Facility
|
IP
|
$30,932.72
|
|
|
Service Code
|
MSDRG 371
|
| Min. Negotiated Rate |
$6,602.40 |
| Max. Negotiated Rate |
$30,932.72 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,602.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,158.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,602.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,917.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,195.72
|
| Rate for Payer: GEHA Medicare |
$18,195.72
|
| Rate for Payer: Humana ChoiceCare |
$20,015.29
|
| Rate for Payer: Humana Medicare Advantage |
$18,195.72
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,568.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,917.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,195.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30,932.72
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,474.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,917.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,195.72
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,019.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,831.81
|
| Rate for Payer: United Healthcare Commercial |
$11,921.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,917.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,195.72
|
| Rate for Payer: Zelis Medicare |
$15,466.36
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,449.40
|
|
|
MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,595.31
|
|
|
Service Code
|
MSDRG 373
|
| Min. Negotiated Rate |
$3,541.65 |
| Max. Negotiated Rate |
$13,595.31 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,541.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,875.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,541.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,513.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,997.24
|
| Rate for Payer: GEHA Medicare |
$7,997.24
|
| Rate for Payer: Humana ChoiceCare |
$8,796.96
|
| Rate for Payer: Humana Medicare Advantage |
$7,997.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,435.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,513.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,997.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,595.31
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,196.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,513.87
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,997.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,436.05
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,837.30
|
| Rate for Payer: United Healthcare Commercial |
$4,947.23
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,513.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,997.24
|
| Rate for Payer: Zelis Medicare |
$6,797.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,751.37
|
|
|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$38,020.01
|
|
|
Service Code
|
MSDRG 141
|
| Min. Negotiated Rate |
$5,674.90 |
| Max. Negotiated Rate |
$38,020.01 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,674.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,402.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,674.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,279.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,364.71
|
| Rate for Payer: GEHA Medicare |
$22,364.71
|
| Rate for Payer: Humana ChoiceCare |
$24,601.18
|
| Rate for Payer: Humana Medicare Advantage |
$22,364.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,572.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,279.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,364.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$38,020.01
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,310.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,279.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,364.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,981.54
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,917.42
|
| Rate for Payer: United Healthcare Commercial |
$14,652.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,279.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,364.71
|
| Rate for Payer: Zelis Medicare |
$19,010.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,072.67
|
|
|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$74,840.26
|
|
|
Service Code
|
MSDRG 140
|
| Min. Negotiated Rate |
$8,754.55 |
| Max. Negotiated Rate |
$74,840.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,754.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$34,256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,754.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,716.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$44,023.68
|
| Rate for Payer: GEHA Medicare |
$44,023.68
|
| Rate for Payer: Humana ChoiceCare |
$48,426.05
|
| Rate for Payer: Humana Medicare Advantage |
$44,023.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$73,959.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,716.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$44,023.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$74,840.26
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$61,633.15
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,716.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$44,023.68
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$62,953.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$43,143.21
|
| Rate for Payer: United Healthcare Commercial |
$28,843.14
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,716.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$44,023.68
|
| Rate for Payer: Zelis Medicare |
$37,420.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$27,701.26
|
|
|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$27,825.29
|
|
|
Service Code
|
MSDRG 142
|
| Min. Negotiated Rate |
$5,442.50 |
| Max. Negotiated Rate |
$27,825.29 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,736.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,869.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,367.82
|
| Rate for Payer: GEHA Medicare |
$16,367.82
|
| Rate for Payer: Humana ChoiceCare |
$18,004.60
|
| Rate for Payer: Humana Medicare Advantage |
$16,367.82
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,497.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,869.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,367.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,825.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,914.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,869.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,367.82
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,405.98
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,040.46
|
| Rate for Payer: United Healthcare Commercial |
$10,723.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,869.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,367.82
|
| Rate for Payer: Zelis Medicare |
$13,912.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,299.22
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
|
IP
|
$21,916.57
|
|
|
Service Code
|
MSDRG 809
|
| Min. Negotiated Rate |
$5,067.30 |
| Max. Negotiated Rate |
$21,916.57 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,067.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,031.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,067.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,207.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,892.10
|
| Rate for Payer: GEHA Medicare |
$12,892.10
|
| Rate for Payer: Humana ChoiceCare |
$14,181.31
|
| Rate for Payer: Humana Medicare Advantage |
$12,892.10
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,658.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,207.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,892.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,916.57
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,048.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,207.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,892.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,435.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,634.26
|
| Rate for Payer: United Healthcare Commercial |
$8,446.57
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,207.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,892.10
|
| Rate for Payer: Zelis Medicare |
$10,958.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,112.18
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
|
IP
|
$40,529.33
|
|
|
Service Code
|
MSDRG 808
|
| Min. Negotiated Rate |
$8,069.25 |
| Max. Negotiated Rate |
$40,529.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,069.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,551.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,069.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,506.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,840.78
|
| Rate for Payer: GEHA Medicare |
$23,840.78
|
| Rate for Payer: Humana ChoiceCare |
$26,224.86
|
| Rate for Payer: Humana Medicare Advantage |
$23,840.78
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$40,052.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,506.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,840.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40,529.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$33,377.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,506.62
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,840.78
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$34,092.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,363.96
|
| Rate for Payer: United Healthcare Commercial |
$15,619.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,506.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,840.78
|
| Rate for Payer: Zelis Medicare |
$20,264.66
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,001.47
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$16,902.44
|
|
|
Service Code
|
MSDRG 810
|
| Min. Negotiated Rate |
$3,710.70 |
| Max. Negotiated Rate |
$16,902.44 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,710.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,709.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,710.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,812.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,942.61
|
| Rate for Payer: GEHA Medicare |
$9,942.61
|
| Rate for Payer: Humana ChoiceCare |
$10,936.87
|
| Rate for Payer: Humana Medicare Advantage |
$9,942.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,703.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,812.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,942.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,902.44
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,919.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,812.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,942.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,217.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,743.76
|
| Rate for Payer: United Healthcare Commercial |
$6,491.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,812.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,942.61
|
| Rate for Payer: Zelis Medicare |
$8,451.22
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,234.29
|
|
|
MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$57,843.15
|
|
|
Service Code
|
MSDRG 469
|
| Min. Negotiated Rate |
$21,018.55 |
| Max. Negotiated Rate |
$57,843.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$21,018.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$26,476.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$21,018.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$37,366.54
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$34,025.38
|
| Rate for Payer: GEHA Medicare |
$34,025.38
|
| Rate for Payer: Humana ChoiceCare |
$37,427.92
|
| Rate for Payer: Humana Medicare Advantage |
$34,025.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$57,162.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$37,366.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$34,025.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$57,843.15
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$47,635.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$37,366.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$34,025.38
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$48,656.29
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$33,344.87
|
| Rate for Payer: United Healthcare Commercial |
$22,292.53
|
| Rate for Payer: United Healthcare Managed Medicaid |
$37,366.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34,025.38
|
| Rate for Payer: Zelis Medicare |
$28,921.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21,409.99
|
|
|
MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$33,365.93
|
|
|
Service Code
|
MSDRG 470
|
| Min. Negotiated Rate |
$12,350.02 |
| Max. Negotiated Rate |
$33,365.93 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,188.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,272.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,188.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25,308.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,627.02
|
| Rate for Payer: GEHA Medicare |
$19,627.02
|
| Rate for Payer: Humana ChoiceCare |
$21,589.72
|
| Rate for Payer: Humana Medicare Advantage |
$19,627.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,973.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25,308.82
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,627.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$33,365.93
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,477.83
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25,308.82
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,627.02
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,066.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,234.48
|
| Rate for Payer: United Healthcare Commercial |
$12,859.11
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25,308.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,627.02
|
| Rate for Payer: Zelis Medicare |
$16,682.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,350.02
|
|
|
MS-DRG 42.00: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$45,093.11
|
|
|
Service Code
|
MSDRG 483
|
| Min. Negotiated Rate |
$8,735.30 |
| Max. Negotiated Rate |
$45,093.11 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,735.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,640.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,735.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,682.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,525.36
|
| Rate for Payer: GEHA Medicare |
$26,525.36
|
| Rate for Payer: Humana ChoiceCare |
$29,177.90
|
| Rate for Payer: Humana Medicare Advantage |
$26,525.36
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$44,562.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,682.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,525.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$45,093.11
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$37,135.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,682.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,525.36
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37,931.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$25,994.85
|
| Rate for Payer: United Healthcare Commercial |
$17,378.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,682.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,525.36
|
| Rate for Payer: Zelis Medicare |
$22,546.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,690.71
|
|
|
MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$34,340.99
|
|
|
Service Code
|
MSDRG 707
|
| Min. Negotiated Rate |
$9,426.90 |
| Max. Negotiated Rate |
$34,340.99 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,426.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,718.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,426.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,903.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,200.58
|
| Rate for Payer: GEHA Medicare |
$20,200.58
|
| Rate for Payer: Humana ChoiceCare |
$22,220.64
|
| Rate for Payer: Humana Medicare Advantage |
$20,200.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$33,936.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,903.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,200.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,340.99
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,280.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,903.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,200.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,886.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,796.57
|
| Rate for Payer: United Healthcare Commercial |
$13,234.89
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,903.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,200.58
|
| Rate for Payer: Zelis Medicare |
$17,170.49
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,710.93
|
|
|
MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$26,234.42
|
|
|
Service Code
|
MSDRG 708
|
| Min. Negotiated Rate |
$7,577.15 |
| Max. Negotiated Rate |
$26,234.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,577.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,008.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,577.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,637.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,432.01
|
| Rate for Payer: GEHA Medicare |
$15,432.01
|
| Rate for Payer: Humana ChoiceCare |
$16,975.21
|
| Rate for Payer: Humana Medicare Advantage |
$15,432.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,925.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,637.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,432.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,234.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,604.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,637.90
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,432.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,067.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,123.37
|
| Rate for Payer: United Healthcare Commercial |
$10,110.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,637.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,432.01
|
| Rate for Payer: Zelis Medicare |
$13,117.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,710.38
|
|
|
MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$34,298.54
|
|
|
Service Code
|
MSDRG 507
|
| Min. Negotiated Rate |
$6,368.25 |
| Max. Negotiated Rate |
$34,298.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,368.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,699.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,368.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,503.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,175.61
|
| Rate for Payer: GEHA Medicare |
$20,175.61
|
| Rate for Payer: Humana ChoiceCare |
$22,193.17
|
| Rate for Payer: Humana Medicare Advantage |
$20,175.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$33,895.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,503.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,175.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,298.54
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,245.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,503.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,175.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,851.12
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,772.10
|
| Rate for Payer: United Healthcare Commercial |
$13,218.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,503.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,175.61
|
| Rate for Payer: Zelis Medicare |
$17,149.27
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,695.21
|
|
|
MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,838.56
|
|
|
Service Code
|
MSDRG 508
|
| Min. Negotiated Rate |
$4,716.25 |
| Max. Negotiated Rate |
$22,838.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,716.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,453.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,716.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,587.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,434.45
|
| Rate for Payer: GEHA Medicare |
$13,434.45
|
| Rate for Payer: Humana ChoiceCare |
$14,777.90
|
| Rate for Payer: Humana Medicare Advantage |
$13,434.45
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,569.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,587.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,434.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,838.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,808.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,587.43
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,434.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,211.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,165.76
|
| Rate for Payer: United Healthcare Commercial |
$8,801.89
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,587.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,434.45
|
| Rate for Payer: Zelis Medicare |
$11,419.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,453.43
|
|
|
MS-DRG 42.00: MAJOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$37,428.97
|
|
|
Service Code
|
MSDRG 595
|
| Min. Negotiated Rate |
$13,853.91 |
| Max. Negotiated Rate |
$37,428.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,948.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,132.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,948.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26,650.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,017.04
|
| Rate for Payer: GEHA Medicare |
$22,017.04
|
| Rate for Payer: Humana ChoiceCare |
$24,218.74
|
| Rate for Payer: Humana Medicare Advantage |
$22,017.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,988.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26,650.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,017.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,428.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,823.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26,650.22
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,017.04
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,484.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,576.70
|
| Rate for Payer: United Healthcare Commercial |
$14,424.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26,650.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,017.04
|
| Rate for Payer: Zelis Medicare |
$18,714.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,853.91
|
|
