|
MS-DRG 42.00: NERVOUS SYSTEM NEOPLASMS WITH MCC
|
Facility
|
IP
|
$26,528.19
|
|
|
Service Code
|
MSDRG 054
|
| Min. Negotiated Rate |
$5,678.75 |
| Max. Negotiated Rate |
$26,528.19 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,678.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,142.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,678.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,286.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,604.82
|
| Rate for Payer: GEHA Medicare |
$15,604.82
|
| Rate for Payer: Humana ChoiceCare |
$17,165.30
|
| Rate for Payer: Humana Medicare Advantage |
$15,604.82
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,216.10
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,286.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,604.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,528.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,846.75
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,286.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,604.82
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,314.89
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,292.72
|
| Rate for Payer: United Healthcare Commercial |
$10,223.86
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,286.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,604.82
|
| Rate for Payer: Zelis Medicare |
$13,264.10
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,819.10
|
|
|
MS-DRG 42.00: NERVOUS SYSTEM NEOPLASMS WITHOUT MCC
|
Facility
|
IP
|
$19,306.41
|
|
|
Service Code
|
MSDRG 055
|
| Min. Negotiated Rate |
$4,917.50 |
| Max. Negotiated Rate |
$19,306.41 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,917.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,837.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,917.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,942.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,356.71
|
| Rate for Payer: GEHA Medicare |
$11,356.71
|
| Rate for Payer: Humana ChoiceCare |
$12,492.38
|
| Rate for Payer: Humana Medicare Advantage |
$11,356.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,079.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,942.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,356.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,306.41
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,899.39
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,942.71
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,356.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,240.10
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,129.58
|
| Rate for Payer: United Healthcare Commercial |
$7,440.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,942.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,356.71
|
| Rate for Payer: Zelis Medicare |
$9,653.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,146.05
|
|
|
MS-DRG 42.00: NEUROLOGICAL EYE DISORDERS
|
Facility
|
IP
|
$14,731.79
|
|
|
Service Code
|
MSDRG 123
|
| Min. Negotiated Rate |
$2,991.10 |
| Max. Negotiated Rate |
$14,731.79 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,991.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,505.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,991.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,541.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,665.76
|
| Rate for Payer: GEHA Medicare |
$8,665.76
|
| Rate for Payer: Humana ChoiceCare |
$9,532.34
|
| Rate for Payer: Humana Medicare Advantage |
$8,665.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,558.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,541.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,665.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,731.79
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,132.06
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,541.96
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,665.76
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,392.04
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,492.44
|
| Rate for Payer: United Healthcare Commercial |
$5,477.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,541.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,665.76
|
| Rate for Payer: Zelis Medicare |
$7,365.90
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,260.96
|
|
|
MS-DRG 42.00: NEUROSES EXCEPT DEPRESSIVE
|
Facility
|
IP
|
$17,051.46
|
|
|
Service Code
|
MSDRG 882
|
| Min. Negotiated Rate |
$3,300.50 |
| Max. Negotiated Rate |
$17,051.46 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,792.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,088.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,030.27
|
| Rate for Payer: GEHA Medicare |
$10,030.27
|
| Rate for Payer: Humana ChoiceCare |
$11,033.30
|
| Rate for Payer: Humana Medicare Advantage |
$10,030.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,850.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,088.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,030.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,051.46
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,042.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,088.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,030.27
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,343.29
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,829.66
|
| Rate for Payer: United Healthcare Commercial |
$6,560.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,088.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,030.27
|
| Rate for Payer: Zelis Medicare |
$8,525.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,301.10
|
|
|
MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC
|
Facility
|
IP
|
$38,388.06
|
|
|
Service Code
|
MSDRG 098
|
| Min. Negotiated Rate |
$8,376.55 |
| Max. Negotiated Rate |
$38,388.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,376.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,571.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,376.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,049.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,581.21
|
| Rate for Payer: GEHA Medicare |
$22,581.21
|
| Rate for Payer: Humana ChoiceCare |
$24,839.33
|
| Rate for Payer: Humana Medicare Advantage |
$22,581.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,936.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,049.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,581.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$38,388.06
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,613.69
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,049.11
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,581.21
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$32,291.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,129.59
|
| Rate for Payer: United Healthcare Commercial |
$14,794.63
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,049.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,581.21
|
| Rate for Payer: Zelis Medicare |
$19,194.03
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,208.92
|
|
|
MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC
|
Facility
|
IP
|
$63,433.34
|
|
|
Service Code
|
MSDRG 097
|
| Min. Negotiated Rate |
$11,416.65 |
| Max. Negotiated Rate |
$63,433.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,416.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$29,035.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,416.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,415.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$37,313.73
|
| Rate for Payer: GEHA Medicare |
$37,313.73
|
| Rate for Payer: Humana ChoiceCare |
$41,045.10
|
| Rate for Payer: Humana Medicare Advantage |
$37,313.73
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$62,687.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,415.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$37,313.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$63,433.34
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$52,239.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,415.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$37,313.73
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$53,358.63
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$36,567.46
|
| Rate for Payer: United Healthcare Commercial |
$24,446.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,415.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37,313.73
|
| Rate for Payer: Zelis Medicare |
$31,716.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23,479.13
|
|
|
MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$24,655.92
|
|
|
Service Code
|
MSDRG 099
|
| Min. Negotiated Rate |
$6,633.90 |
| Max. Negotiated Rate |
$24,655.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,633.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,285.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,633.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,972.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,503.48
|
| Rate for Payer: GEHA Medicare |
$14,503.48
|
| Rate for Payer: Humana ChoiceCare |
$15,953.83
|
| Rate for Payer: Humana Medicare Advantage |
$14,503.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,365.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,972.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,503.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,655.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,304.87
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,972.74
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,503.48
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,739.98
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,213.41
|
| Rate for Payer: United Healthcare Commercial |
$9,502.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,972.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,503.48
|
| Rate for Payer: Zelis Medicare |
$12,327.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,126.11
|
|
|
MS-DRG 42.00: NON-EXTENSIVE BURNS
|
Facility
|
IP
|
$38,867.64
|
|
|
Service Code
|
MSDRG 935
|
| Min. Negotiated Rate |
$2,542.75 |
| Max. Negotiated Rate |
$38,867.64 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,542.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,790.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,542.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,750.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,863.32
|
| Rate for Payer: GEHA Medicare |
$22,863.32
|
| Rate for Payer: Humana ChoiceCare |
$25,149.65
|
| Rate for Payer: Humana Medicare Advantage |
$22,863.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$38,410.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,750.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,863.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$38,867.64
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,008.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,750.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,863.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$32,694.55
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,406.05
|
| Rate for Payer: United Healthcare Commercial |
$14,979.45
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,750.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,863.32
|
| Rate for Payer: Zelis Medicare |
$19,433.82
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,386.42
|
|
|
MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$30,366.45
|
|
|
Service Code
|
MSDRG 988
|
| Min. Negotiated Rate |
$5,133.45 |
| Max. Negotiated Rate |
$30,366.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,133.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,899.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,133.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,323.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,862.62
|
| Rate for Payer: GEHA Medicare |
$17,862.62
|
| Rate for Payer: Humana ChoiceCare |
$19,648.88
|
| Rate for Payer: Humana Medicare Advantage |
$17,862.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,009.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,323.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,862.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30,366.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,007.67
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,323.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,862.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$25,543.55
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,505.37
|
| Rate for Payer: United Healthcare Commercial |
$11,703.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,323.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,862.62
|
| Rate for Payer: Zelis Medicare |
$15,183.23
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,239.80
|
|
|
MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$61,984.02
|
|
|
Service Code
|
MSDRG 987
|
| Min. Negotiated Rate |
$10,637.20 |
| Max. Negotiated Rate |
$61,984.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,637.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,371.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,637.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,039.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$36,461.19
|
| Rate for Payer: GEHA Medicare |
$36,461.19
|
| Rate for Payer: Humana ChoiceCare |
$40,107.31
|
| Rate for Payer: Humana Medicare Advantage |
$36,461.19
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$61,254.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,039.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$36,461.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$61,984.02
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$51,045.67
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,039.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$36,461.19
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$52,139.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$35,731.97
|
| Rate for Payer: United Healthcare Commercial |
$23,888.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,039.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,461.19
|
| Rate for Payer: Zelis Medicare |
$30,992.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,942.69
|
|
|
MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$20,447.80
|
|
|
Service Code
|
MSDRG 989
|
| Min. Negotiated Rate |
$3,069.85 |
| Max. Negotiated Rate |
$20,447.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,069.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,359.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,069.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,680.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,028.12
|
| Rate for Payer: GEHA Medicare |
$12,028.12
|
| Rate for Payer: Humana ChoiceCare |
$13,230.93
|
| Rate for Payer: Humana Medicare Advantage |
$12,028.12
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,207.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,680.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,028.12
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,447.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,839.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,680.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,028.12
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,200.21
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,787.56
|
| Rate for Payer: United Healthcare Commercial |
$7,880.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,680.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,028.12
|
| Rate for Payer: Zelis Medicare |
$10,223.90
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,568.52
|
|
|
MS-DRG 42.00: NON-MALIGNANT BREAST DISORDERS WITH CC/MCC
|
Facility
|
IP
|
$16,972.56
|
|
|
Service Code
|
MSDRG 600
|
| Min. Negotiated Rate |
$3,690.40 |
| Max. Negotiated Rate |
$16,972.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,690.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,748.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,690.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,776.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,983.86
|
| Rate for Payer: GEHA Medicare |
$9,983.86
|
| Rate for Payer: Humana ChoiceCare |
$10,982.25
|
| Rate for Payer: Humana Medicare Advantage |
$9,983.86
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,772.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,776.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,983.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,972.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,977.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,776.46
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,983.86
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,276.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,784.18
|
| Rate for Payer: United Healthcare Commercial |
$6,524.01
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,776.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,983.86
|
| Rate for Payer: Zelis Medicare |
$8,486.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,265.73
|
|
|
MS-DRG 42.00: NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$11,756.23
|
|
|
Service Code
|
MSDRG 601
|
| Min. Negotiated Rate |
$2,572.50 |
| Max. Negotiated Rate |
$11,756.23 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,572.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,855.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,572.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,802.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,915.43
|
| Rate for Payer: GEHA Medicare |
$6,915.43
|
| Rate for Payer: Humana ChoiceCare |
$7,606.97
|
| Rate for Payer: Humana Medicare Advantage |
$6,915.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,617.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,802.99
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,915.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,756.23
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9,681.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,802.99
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,915.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9,889.06
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,777.12
|
| Rate for Payer: United Healthcare Commercial |
$4,088.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,802.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,915.43
|
| Rate for Payer: Zelis Medicare |
$5,878.12
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,926.72
|
|
|
MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC
|
Facility
|
IP
|
$18,649.90
|
|
|
Service Code
|
MSDRG 071
|
| Min. Negotiated Rate |
$6,903.05 |
| Max. Negotiated Rate |
$18,649.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,883.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,536.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,883.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,179.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,970.53
|
| Rate for Payer: GEHA Medicare |
$10,970.53
|
| Rate for Payer: Humana ChoiceCare |
$12,067.58
|
| Rate for Payer: Humana Medicare Advantage |
$10,970.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,430.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,179.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,970.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,649.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,358.74
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,179.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,970.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,687.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,751.12
|
| Rate for Payer: United Healthcare Commercial |
$7,187.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,179.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,970.53
|
| Rate for Payer: Zelis Medicare |
$9,324.95
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,903.05
|
|
|
MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$30,769.92
|
|
|
Service Code
|
MSDRG 070
|
| Min. Negotiated Rate |
$11,389.14 |
| Max. Negotiated Rate |
$30,769.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$13,063.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,084.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$13,063.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23,322.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,099.95
|
| Rate for Payer: GEHA Medicare |
$18,099.95
|
| Rate for Payer: Humana ChoiceCare |
$19,909.94
|
| Rate for Payer: Humana Medicare Advantage |
$18,099.95
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,407.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23,322.99
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,099.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30,769.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,339.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23,322.99
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,099.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$25,882.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,737.95
|
| Rate for Payer: United Healthcare Commercial |
$11,858.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23,322.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,099.95
|
| Rate for Payer: Zelis Medicare |
$15,384.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,389.14
|
|
|
MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,957.58
|
|
|
Service Code
|
MSDRG 072
|
| Min. Negotiated Rate |
$4,913.81 |
| Max. Negotiated Rate |
$13,957.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,296.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,076.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,296.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,612.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,210.34
|
| Rate for Payer: GEHA Medicare |
$8,210.34
|
| Rate for Payer: Humana ChoiceCare |
$9,031.37
|
| Rate for Payer: Humana Medicare Advantage |
$8,210.34
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,793.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,612.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,210.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,957.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,494.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,612.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,210.34
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,740.79
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,046.13
|
| Rate for Payer: United Healthcare Commercial |
$5,116.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,612.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,210.34
|
| Rate for Payer: Zelis Medicare |
$6,978.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,913.81
|
|
|
MS-DRG 42.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC
|
Facility
|
IP
|
$25,746.02
|
|
|
Service Code
|
MSDRG 067
|
| Min. Negotiated Rate |
$9,158.10 |
| Max. Negotiated Rate |
$25,746.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,158.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,784.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,158.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,428.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,144.72
|
| Rate for Payer: GEHA Medicare |
$15,144.72
|
| Rate for Payer: Humana ChoiceCare |
$16,659.19
|
| Rate for Payer: Humana Medicare Advantage |
$15,144.72
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,443.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,428.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,144.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,746.02
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,202.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,428.81
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,144.72
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,656.95
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,841.83
|
| Rate for Payer: United Healthcare Commercial |
$9,922.42
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,428.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,144.72
|
| Rate for Payer: Zelis Medicare |
$12,873.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,529.59
|
|
|
MS-DRG 42.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC
|
Facility
|
IP
|
$15,875.53
|
|
|
Service Code
|
MSDRG 068
|
| Min. Negotiated Rate |
$5,773.82 |
| Max. Negotiated Rate |
$15,875.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,969.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,140.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,969.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,799.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,338.55
|
| Rate for Payer: GEHA Medicare |
$9,338.55
|
| Rate for Payer: Humana ChoiceCare |
$10,272.41
|
| Rate for Payer: Humana Medicare Advantage |
$9,338.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,688.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,799.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,338.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,875.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,073.97
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,799.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,338.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,354.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,151.78
|
| Rate for Payer: United Healthcare Commercial |
$6,011.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,799.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,338.55
|
| Rate for Payer: Zelis Medicare |
$7,937.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,773.82
|
|
|
MS-DRG 42.00: NONTRAUMATIC STUPOR AND COMA WITH MCC
|
Facility
|
IP
|
$35,176.26
|
|
|
Service Code
|
MSDRG 080
|
| Min. Negotiated Rate |
$5,707.80 |
| Max. Negotiated Rate |
$35,176.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,707.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,101.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,707.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,337.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,691.92
|
| Rate for Payer: GEHA Medicare |
$20,691.92
|
| Rate for Payer: Humana ChoiceCare |
$22,761.11
|
| Rate for Payer: Humana Medicare Advantage |
$20,691.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,762.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,337.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,691.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,176.26
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,968.69
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,337.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,691.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,589.45
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,278.08
|
| Rate for Payer: United Healthcare Commercial |
$13,556.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,337.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,691.92
|
| Rate for Payer: Zelis Medicare |
$17,588.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,020.09
|
|
|
MS-DRG 42.00: NONTRAUMATIC STUPOR AND COMA WITHOUT MCC
|
Facility
|
IP
|
$16,215.89
|
|
|
Service Code
|
MSDRG 081
|
| Min. Negotiated Rate |
$4,194.05 |
| Max. Negotiated Rate |
$16,215.89 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,194.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,328.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,194.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,665.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,538.76
|
| Rate for Payer: GEHA Medicare |
$9,538.76
|
| Rate for Payer: Humana ChoiceCare |
$10,492.64
|
| Rate for Payer: Humana Medicare Advantage |
$9,538.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,025.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,665.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,538.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,215.89
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,354.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,665.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,538.76
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,640.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,347.98
|
| Rate for Payer: United Healthcare Commercial |
$6,170.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,665.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,538.76
|
| Rate for Payer: Zelis Medicare |
$8,107.95
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,926.44
|
|
|
MS-DRG 42.00: NORMAL NEWBORN
|
Facility
|
IP
|
$5,917.58
|
|
|
Service Code
|
MSDRG 795
|
| Min. Negotiated Rate |
$428.40 |
| Max. Negotiated Rate |
$5,917.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$428.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,618.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$428.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,017.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,480.93
|
| Rate for Payer: GEHA Medicare |
$3,480.93
|
| Rate for Payer: Humana ChoiceCare |
$3,829.02
|
| Rate for Payer: Humana Medicare Advantage |
$3,480.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,847.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,017.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,480.93
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,917.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,873.30
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,017.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,480.93
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$4,977.73
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,411.31
|
| Rate for Payer: United Healthcare Commercial |
$1,362.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,017.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,480.93
|
| Rate for Payer: Zelis Medicare |
$2,958.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,308.69
|
|
|
MS-DRG 42.00: ORBITAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$39,932.93
|
|
|
Service Code
|
MSDRG 113
|
| Min. Negotiated Rate |
$4,620.70 |
| Max. Negotiated Rate |
$39,932.93 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,620.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,278.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,620.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,418.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,489.96
|
| Rate for Payer: GEHA Medicare |
$23,489.96
|
| Rate for Payer: Humana ChoiceCare |
$25,838.96
|
| Rate for Payer: Humana Medicare Advantage |
$23,489.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,463.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,418.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,489.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39,932.93
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,885.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,418.76
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,489.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,590.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,020.16
|
| Rate for Payer: United Healthcare Commercial |
$15,390.01
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,418.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,489.96
|
| Rate for Payer: Zelis Medicare |
$19,966.47
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,780.73
|
|
|
MS-DRG 42.00: ORBITAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,918.50
|
|
|
Service Code
|
MSDRG 114
|
| Min. Negotiated Rate |
$3,421.95 |
| Max. Negotiated Rate |
$20,918.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,421.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,575.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,421.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,302.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,305.00
|
| Rate for Payer: GEHA Medicare |
$12,305.00
|
| Rate for Payer: Humana ChoiceCare |
$13,535.50
|
| Rate for Payer: Humana Medicare Advantage |
$12,305.00
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,672.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,302.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,305.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,918.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,227.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,302.56
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,305.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,596.15
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,058.90
|
| Rate for Payer: United Healthcare Commercial |
$8,061.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,302.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,305.00
|
| Rate for Payer: Zelis Medicare |
$10,459.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,742.76
|
|
|
MS-DRG 42.00: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY
|
Facility
|
IP
|
$29,555.96
|
|
|
Service Code
|
MSDRG 884
|
| Min. Negotiated Rate |
$4,558.40 |
| Max. Negotiated Rate |
$29,555.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,558.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,528.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,558.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,308.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,385.86
|
| Rate for Payer: GEHA Medicare |
$17,385.86
|
| Rate for Payer: Humana ChoiceCare |
$19,124.45
|
| Rate for Payer: Humana Medicare Advantage |
$17,385.86
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,208.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,308.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,385.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,555.96
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,340.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,308.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,385.86
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,861.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,038.14
|
| Rate for Payer: United Healthcare Commercial |
$11,390.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,308.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,385.86
|
| Rate for Payer: Zelis Medicare |
$14,777.98
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,939.81
|
|
|
MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH CC
|
Facility
|
IP
|
$28,260.63
|
|
|
Service Code
|
MSDRG 620
|
| Min. Negotiated Rate |
$8,273.30 |
| Max. Negotiated Rate |
$28,260.63 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,273.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,935.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,273.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,866.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,623.90
|
| Rate for Payer: GEHA Medicare |
$16,623.90
|
| Rate for Payer: Humana ChoiceCare |
$18,286.29
|
| Rate for Payer: Humana Medicare Advantage |
$16,623.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,928.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,866.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,623.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,260.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,273.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,866.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,623.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,772.18
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,291.42
|
| Rate for Payer: United Healthcare Commercial |
$10,891.54
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,866.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,623.90
|
| Rate for Payer: Zelis Medicare |
$14,130.32
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,460.35
|
|
