|
MS-DRG 42.00: MINOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,108.22
|
|
|
Service Code
|
MSDRG 664
|
| Min. Negotiated Rate |
$3,578.40 |
| Max. Negotiated Rate |
$19,108.22 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,578.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,746.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,578.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,578.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,240.13
|
| Rate for Payer: GEHA Medicare |
$11,240.13
|
| Rate for Payer: Humana ChoiceCare |
$12,364.14
|
| Rate for Payer: Humana Medicare Advantage |
$11,240.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,883.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,578.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,240.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,108.22
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,736.18
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,578.74
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,240.13
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,073.39
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,015.33
|
| Rate for Payer: United Healthcare Commercial |
$7,364.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,578.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,240.13
|
| Rate for Payer: Zelis Medicare |
$9,554.11
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,072.69
|
|
|
MS-DRG 42.00: MINOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$28,495.96
|
|
|
Service Code
|
MSDRG 606
|
| Min. Negotiated Rate |
$4,119.50 |
| Max. Negotiated Rate |
$28,495.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,119.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,043.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,119.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,533.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,762.33
|
| Rate for Payer: GEHA Medicare |
$16,762.33
|
| Rate for Payer: Humana ChoiceCare |
$18,438.56
|
| Rate for Payer: Humana Medicare Advantage |
$16,762.33
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,160.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,533.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,762.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,495.96
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,467.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,533.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,762.33
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,970.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,427.08
|
| Rate for Payer: United Healthcare Commercial |
$10,982.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,533.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,762.33
|
| Rate for Payer: Zelis Medicare |
$14,247.98
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,547.47
|
|
|
MS-DRG 42.00: MINOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$15,622.83
|
|
|
Service Code
|
MSDRG 607
|
| Min. Negotiated Rate |
$2,199.05 |
| Max. Negotiated Rate |
$15,622.83 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,199.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,000.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,199.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,143.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,189.90
|
| Rate for Payer: GEHA Medicare |
$9,189.90
|
| Rate for Payer: Humana ChoiceCare |
$10,108.89
|
| Rate for Payer: Humana Medicare Advantage |
$9,189.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,439.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,143.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,189.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,622.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,865.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,143.72
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,189.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,141.56
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,006.10
|
| Rate for Payer: United Healthcare Commercial |
$5,893.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,143.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,189.90
|
| Rate for Payer: Zelis Medicare |
$7,811.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,660.51
|
|
|
MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$26,344.13
|
|
|
Service Code
|
MSDRG 345
|
| Min. Negotiated Rate |
$7,551.60 |
| Max. Negotiated Rate |
$26,344.13 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,551.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,058.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,551.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,592.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,496.55
|
| Rate for Payer: GEHA Medicare |
$15,496.55
|
| Rate for Payer: Humana ChoiceCare |
$17,046.21
|
| Rate for Payer: Humana Medicare Advantage |
$15,496.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,034.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,592.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,496.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,344.13
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,695.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,592.79
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,496.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,160.07
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,186.62
|
| Rate for Payer: United Healthcare Commercial |
$10,152.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,592.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,496.55
|
| Rate for Payer: Zelis Medicare |
$13,172.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,750.99
|
|
|
MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$47,682.06
|
|
|
Service Code
|
MSDRG 344
|
| Min. Negotiated Rate |
$10,959.90 |
| Max. Negotiated Rate |
$47,682.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,959.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21,825.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,959.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,609.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$28,048.27
|
| Rate for Payer: GEHA Medicare |
$28,048.27
|
| Rate for Payer: Humana ChoiceCare |
$30,853.10
|
| Rate for Payer: Humana Medicare Advantage |
$28,048.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$47,121.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,609.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$28,048.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$47,682.06
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$39,267.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,609.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$28,048.27
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$40,109.03
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27,487.30
|
| Rate for Payer: United Healthcare Commercial |
$18,376.49
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,609.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28,048.27
|
| Rate for Payer: Zelis Medicare |
$23,841.03
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,648.97
|
|
|
MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,036.93
|
|
|
Service Code
|
MSDRG 346
|
| Min. Negotiated Rate |
$6,421.80 |
| Max. Negotiated Rate |
$22,036.93 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,421.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,086.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,421.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,598.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,962.90
|
| Rate for Payer: GEHA Medicare |
$12,962.90
|
| Rate for Payer: Humana ChoiceCare |
$14,259.19
|
| Rate for Payer: Humana Medicare Advantage |
$12,962.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,777.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,598.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,962.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,036.93
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,148.06
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,598.31
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,962.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,536.95
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,703.64
|
| Rate for Payer: United Healthcare Commercial |
$8,492.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,598.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,962.90
|
| Rate for Payer: Zelis Medicare |
$11,018.47
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,156.72
|
|
|
MS-DRG 42.00: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC
|
Facility
|
IP
|
$23,500.39
|
|
|
Service Code
|
MSDRG 640
|
| Min. Negotiated Rate |
$7,139.65 |
| Max. Negotiated Rate |
$23,500.39 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,139.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,756.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,139.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,865.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,823.76
|
| Rate for Payer: GEHA Medicare |
$13,823.76
|
| Rate for Payer: Humana ChoiceCare |
$15,206.14
|
| Rate for Payer: Humana Medicare Advantage |
$13,823.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,223.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,865.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,823.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,500.39
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,353.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,865.56
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,823.76
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,767.98
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,547.28
|
| Rate for Payer: United Healthcare Commercial |
$9,056.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,865.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,823.76
|
| Rate for Payer: Zelis Medicare |
$11,750.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,698.40
|
|
|
MS-DRG 42.00: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC
|
Facility
|
IP
|
$14,413.33
|
|
|
Service Code
|
MSDRG 641
|
| Min. Negotiated Rate |
$3,295.25 |
| Max. Negotiated Rate |
$14,413.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,295.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,329.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,295.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,078.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,478.43
|
| Rate for Payer: GEHA Medicare |
$8,478.43
|
| Rate for Payer: Humana ChoiceCare |
$9,326.27
|
| Rate for Payer: Humana Medicare Advantage |
$8,478.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,243.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,078.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,478.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,413.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,869.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,078.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,478.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,124.15
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,308.86
|
| Rate for Payer: United Healthcare Commercial |
$5,329.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,078.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,478.43
|
| Rate for Payer: Zelis Medicare |
$7,206.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,118.17
|
|
|
MS-DRG 42.00: MOUTH PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$24,749.74
|
|
|
Service Code
|
MSDRG 137
|
| Min. Negotiated Rate |
$5,161.45 |
| Max. Negotiated Rate |
$24,749.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,161.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,328.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,161.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,373.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,558.67
|
| Rate for Payer: GEHA Medicare |
$14,558.67
|
| Rate for Payer: Humana ChoiceCare |
$16,014.54
|
| Rate for Payer: Humana Medicare Advantage |
$14,558.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,458.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,373.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,558.67
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,749.74
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,382.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,373.36
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,558.67
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,818.90
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,267.50
|
| Rate for Payer: United Healthcare Commercial |
$9,538.45
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,373.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,558.67
|
| Rate for Payer: Zelis Medicare |
$12,374.87
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,160.83
|
|
|
MS-DRG 42.00: MOUTH PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$14,882.23
|
|
|
Service Code
|
MSDRG 138
|
| Min. Negotiated Rate |
$3,460.45 |
| Max. Negotiated Rate |
$14,882.23 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,460.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,589.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,460.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,370.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,754.25
|
| Rate for Payer: GEHA Medicare |
$8,754.25
|
| Rate for Payer: Humana ChoiceCare |
$9,629.67
|
| Rate for Payer: Humana Medicare Advantage |
$8,754.25
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,707.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,370.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,754.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,882.23
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,255.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,370.52
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,754.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,518.58
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,579.17
|
| Rate for Payer: United Healthcare Commercial |
$5,548.07
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,370.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,754.25
|
| Rate for Payer: Zelis Medicare |
$7,441.11
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,328.43
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC
|
Facility
|
IP
|
$125,689.89
|
|
|
Service Code
|
MSDRG 427
|
| Min. Negotiated Rate |
$21,888.65 |
| Max. Negotiated Rate |
$125,689.89 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$21,888.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$57,531.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$21,888.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$38,902.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$73,935.23
|
| Rate for Payer: GEHA Medicare |
$73,935.23
|
| Rate for Payer: Humana ChoiceCare |
$81,328.75
|
| Rate for Payer: Humana Medicare Advantage |
$73,935.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$124,211.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$38,902.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$73,935.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$125,689.89
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$103,509.32
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$38,902.56
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$73,935.23
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$105,727.38
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$72,456.53
|
| Rate for Payer: United Healthcare Commercial |
$48,440.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$38,902.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$73,935.23
|
| Rate for Payer: Zelis Medicare |
$62,844.95
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$46,522.68
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$185,373.39
|
|
|
Service Code
|
MSDRG 426
|
| Min. Negotiated Rate |
$33,399.10 |
| Max. Negotiated Rate |
$185,373.39 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$33,399.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$84,850.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$33,399.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$59,222.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$109,043.17
|
| Rate for Payer: GEHA Medicare |
$109,043.17
|
| Rate for Payer: Humana ChoiceCare |
$119,947.49
|
| Rate for Payer: Humana Medicare Advantage |
$109,043.17
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$183,192.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$59,222.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$109,043.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$185,373.39
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$152,660.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$59,222.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$109,043.17
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$155,931.73
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$106,862.31
|
| Rate for Payer: United Healthcare Commercial |
$71,442.23
|
| Rate for Payer: United Healthcare Managed Medicaid |
$59,222.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$109,043.17
|
| Rate for Payer: Zelis Medicare |
$92,686.69
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$68,613.87
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC
|
Facility
|
IP
|
$97,400.94
|
|
|
Service Code
|
MSDRG 428
|
| Min. Negotiated Rate |
$18,996.60 |
| Max. Negotiated Rate |
$97,400.94 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$18,996.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$44,583.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$18,996.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$33,797.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$57,294.67
|
| Rate for Payer: GEHA Medicare |
$57,294.67
|
| Rate for Payer: Humana ChoiceCare |
$63,024.14
|
| Rate for Payer: Humana Medicare Advantage |
$57,294.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$96,255.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$33,797.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$57,294.67
|
| Rate for Payer: New Mexico Health Connections Medicare |
$97,400.94
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$80,212.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$33,797.11
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$57,294.67
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$81,931.38
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$56,148.78
|
| Rate for Payer: United Healthcare Commercial |
$37,537.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$33,797.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$57,294.67
|
| Rate for Payer: Zelis Medicare |
$48,700.47
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$36,051.86
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$118,646.88
|
|
|
Service Code
|
MSDRG 447
|
| Min. Negotiated Rate |
$23,917.60 |
| Max. Negotiated Rate |
$118,646.88 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$23,917.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$54,308.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$23,917.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$42,484.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$69,792.28
|
| Rate for Payer: GEHA Medicare |
$69,792.28
|
| Rate for Payer: Humana ChoiceCare |
$76,771.51
|
| Rate for Payer: Humana Medicare Advantage |
$69,792.28
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$117,251.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$42,484.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$69,792.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$118,646.88
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$97,709.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$42,484.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$69,792.28
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$99,802.96
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$68,396.43
|
| Rate for Payer: United Healthcare Commercial |
$45,726.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$42,484.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$69,792.28
|
| Rate for Payer: Zelis Medicare |
$59,323.44
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$43,915.79
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$72,261.92
|
|
|
Service Code
|
MSDRG 448
|
| Min. Negotiated Rate |
$14,430.85 |
| Max. Negotiated Rate |
$72,261.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,430.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33,076.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,430.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25,737.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$42,507.01
|
| Rate for Payer: GEHA Medicare |
$42,507.01
|
| Rate for Payer: Humana ChoiceCare |
$46,757.71
|
| Rate for Payer: Humana Medicare Advantage |
$42,507.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$71,411.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25,737.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$42,507.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$72,261.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$59,509.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25,737.01
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$42,507.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$60,785.02
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$41,656.87
|
| Rate for Payer: United Healthcare Commercial |
$27,849.47
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25,737.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42,507.01
|
| Rate for Payer: Zelis Medicare |
$36,130.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$26,746.92
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC
|
Facility
|
IP
|
$21,652.92
|
|
|
Service Code
|
MSDRG 059
|
| Min. Negotiated Rate |
$4,611.25 |
| Max. Negotiated Rate |
$21,652.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,611.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,911.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,611.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,402.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,737.01
|
| Rate for Payer: GEHA Medicare |
$12,737.01
|
| Rate for Payer: Humana ChoiceCare |
$14,010.71
|
| Rate for Payer: Humana Medicare Advantage |
$12,737.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,398.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,402.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,737.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,652.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,831.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,402.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,737.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,213.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,482.27
|
| Rate for Payer: United Healthcare Commercial |
$8,344.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,402.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,737.01
|
| Rate for Payer: Zelis Medicare |
$10,826.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,014.58
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC
|
Facility
|
IP
|
$32,665.16
|
|
|
Service Code
|
MSDRG 058
|
| Min. Negotiated Rate |
$5,358.50 |
| Max. Negotiated Rate |
$32,665.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,358.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,951.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,358.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,721.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,214.80
|
| Rate for Payer: GEHA Medicare |
$19,214.80
|
| Rate for Payer: Humana ChoiceCare |
$21,136.28
|
| Rate for Payer: Humana Medicare Advantage |
$19,214.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,280.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,721.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,214.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,665.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,900.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,721.22
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,214.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,477.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,830.50
|
| Rate for Payer: United Healthcare Commercial |
$12,589.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,721.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,214.80
|
| Rate for Payer: Zelis Medicare |
$16,332.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,090.65
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC
|
Facility
|
IP
|
$16,034.76
|
|
|
Service Code
|
MSDRG 060
|
| Min. Negotiated Rate |
$3,403.05 |
| Max. Negotiated Rate |
$16,034.76 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,403.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,228.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,403.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,269.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,432.21
|
| Rate for Payer: GEHA Medicare |
$9,432.21
|
| Rate for Payer: Humana ChoiceCare |
$10,375.43
|
| Rate for Payer: Humana Medicare Advantage |
$9,432.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,846.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,269.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,432.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,034.76
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,205.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,269.19
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,432.21
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,488.06
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,243.57
|
| Rate for Payer: United Healthcare Commercial |
$6,086.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,269.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,432.21
|
| Rate for Payer: Zelis Medicare |
$8,017.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,845.22
|
|
|
MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$41,760.94
|
|
|
Service Code
|
MSDRG 827
|
| Min. Negotiated Rate |
$11,816.70 |
| Max. Negotiated Rate |
$41,760.94 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,816.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,115.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,816.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21,122.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,565.26
|
| Rate for Payer: GEHA Medicare |
$24,565.26
|
| Rate for Payer: Humana ChoiceCare |
$27,021.79
|
| Rate for Payer: Humana Medicare Advantage |
$24,565.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$41,269.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21,122.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,565.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$41,760.94
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$34,391.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21,122.14
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,565.26
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35,128.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,073.95
|
| Rate for Payer: United Healthcare Commercial |
$16,094.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21,122.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,565.26
|
| Rate for Payer: Zelis Medicare |
$20,880.47
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,457.34
|
|
|
MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$84,507.56
|
|
|
Service Code
|
MSDRG 826
|
| Min. Negotiated Rate |
$16,367.40 |
| Max. Negotiated Rate |
$84,507.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,367.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$38,681.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,367.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$29,155.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$49,710.33
|
| Rate for Payer: GEHA Medicare |
$49,710.33
|
| Rate for Payer: Humana ChoiceCare |
$54,681.36
|
| Rate for Payer: Humana Medicare Advantage |
$49,710.33
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$83,513.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$29,155.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$49,710.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$84,507.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$69,594.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$29,155.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$49,710.33
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$71,085.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$48,716.12
|
| Rate for Payer: United Healthcare Commercial |
$32,568.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$29,155.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$49,710.33
|
| Rate for Payer: Zelis Medicare |
$42,253.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$31,279.53
|
|
|
MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$28,365.03
|
|
|
Service Code
|
MSDRG 828
|
| Min. Negotiated Rate |
$7,512.75 |
| Max. Negotiated Rate |
$28,365.03 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,512.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,983.49
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,512.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,524.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,685.31
|
| Rate for Payer: GEHA Medicare |
$16,685.31
|
| Rate for Payer: Humana ChoiceCare |
$18,353.84
|
| Rate for Payer: Humana Medicare Advantage |
$16,685.31
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,031.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,524.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,685.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,365.03
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,359.43
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,524.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,685.31
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,859.99
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,351.60
|
| Rate for Payer: United Healthcare Commercial |
$10,931.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,524.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,685.31
|
| Rate for Payer: Zelis Medicare |
$14,182.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,499.00
|
|
|
MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$54,571.12
|
|
|
Service Code
|
MSDRG 829
|
| Min. Negotiated Rate |
$8,823.50 |
| Max. Negotiated Rate |
$54,571.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,823.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$24,978.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,823.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,838.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$32,100.66
|
| Rate for Payer: GEHA Medicare |
$32,100.66
|
| Rate for Payer: Humana ChoiceCare |
$35,310.73
|
| Rate for Payer: Humana Medicare Advantage |
$32,100.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$53,929.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,838.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$32,100.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$54,571.12
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$44,940.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,838.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$32,100.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$45,903.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$31,458.65
|
| Rate for Payer: United Healthcare Commercial |
$21,031.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,838.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,100.66
|
| Rate for Payer: Zelis Medicare |
$27,285.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,198.89
|
|
|
MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$25,880.49
|
|
|
Service Code
|
MSDRG 830
|
| Min. Negotiated Rate |
$6,596.45 |
| Max. Negotiated Rate |
$25,880.49 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,596.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,846.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,596.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,906.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,223.82
|
| Rate for Payer: GEHA Medicare |
$15,223.82
|
| Rate for Payer: Humana ChoiceCare |
$16,746.20
|
| Rate for Payer: Humana Medicare Advantage |
$15,223.82
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,576.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,906.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,223.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,880.49
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,313.35
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,906.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,223.82
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,770.06
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,919.34
|
| Rate for Payer: United Healthcare Commercial |
$9,974.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,906.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,223.82
|
| Rate for Payer: Zelis Medicare |
$12,940.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,579.38
|
|
|
MS-DRG 42.00: NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY
|
Facility
|
IP
|
$31,898.92
|
|
|
Service Code
|
MSDRG 789
|
| Min. Negotiated Rate |
$10,786.65 |
| Max. Negotiated Rate |
$31,898.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,786.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,601.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,786.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,303.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,764.07
|
| Rate for Payer: GEHA Medicare |
$18,764.07
|
| Rate for Payer: Humana ChoiceCare |
$20,640.48
|
| Rate for Payer: Humana Medicare Advantage |
$18,764.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,523.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,303.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,764.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,898.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,269.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,303.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,764.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,832.62
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,388.79
|
| Rate for Payer: United Healthcare Commercial |
$12,293.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,303.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,764.07
|
| Rate for Payer: Zelis Medicare |
$15,949.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,807.03
|
|
|
MS-DRG 42.00: NEONATE WITH OTHER SIGNIFICANT PROBLEMS
|
Facility
|
IP
|
$26,122.95
|
|
|
Service Code
|
MSDRG 794
|
| Min. Negotiated Rate |
$906.15 |
| Max. Negotiated Rate |
$26,122.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$906.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,957.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$906.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,861.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,366.44
|
| Rate for Payer: GEHA Medicare |
$15,366.44
|
| Rate for Payer: Humana ChoiceCare |
$16,903.08
|
| Rate for Payer: Humana Medicare Advantage |
$15,366.44
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,815.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,861.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,366.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,122.95
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,513.02
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,861.31
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,366.44
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,974.01
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,059.11
|
| Rate for Payer: United Healthcare Commercial |
$10,067.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,861.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,366.44
|
| Rate for Payer: Zelis Medicare |
$13,061.47
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,669.11
|
|
