|
MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH MCC
|
Facility
|
IP
|
$48,248.33
|
|
|
Service Code
|
MSDRG 619
|
| Min. Negotiated Rate |
$14,940.80 |
| Max. Negotiated Rate |
$48,248.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,940.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$22,084.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,940.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26,637.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$28,381.37
|
| Rate for Payer: GEHA Medicare |
$28,381.37
|
| Rate for Payer: Humana ChoiceCare |
$31,219.51
|
| Rate for Payer: Humana Medicare Advantage |
$28,381.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$47,680.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26,637.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$28,381.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$48,248.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$39,733.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26,637.24
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$28,381.37
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$40,585.36
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27,813.74
|
| Rate for Payer: United Healthcare Commercial |
$18,594.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26,637.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28,381.37
|
| Rate for Payer: Zelis Medicare |
$24,124.16
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,858.58
|
|
|
MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC
|
Facility
|
IP
|
$25,868.08
|
|
|
Service Code
|
MSDRG 621
|
| Min. Negotiated Rate |
$6,863.85 |
| Max. Negotiated Rate |
$25,868.08 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,863.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,840.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,863.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,378.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,216.52
|
| Rate for Payer: GEHA Medicare |
$15,216.52
|
| Rate for Payer: Humana ChoiceCare |
$16,738.17
|
| Rate for Payer: Humana Medicare Advantage |
$15,216.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,563.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,378.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,216.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,868.08
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,303.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,378.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,216.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,759.62
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,912.19
|
| Rate for Payer: United Healthcare Commercial |
$9,969.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,378.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,216.52
|
| Rate for Payer: Zelis Medicare |
$12,934.04
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,574.79
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC
|
Facility
|
IP
|
$37,363.47
|
|
|
Service Code
|
MSDRG 940
|
| Min. Negotiated Rate |
$7,907.20 |
| Max. Negotiated Rate |
$37,363.47 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,907.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,102.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,907.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,220.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,978.51
|
| Rate for Payer: GEHA Medicare |
$21,978.51
|
| Rate for Payer: Humana ChoiceCare |
$24,176.36
|
| Rate for Payer: Humana Medicare Advantage |
$21,978.51
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,923.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,220.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,978.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,363.47
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,769.91
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,220.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,978.51
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,429.27
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,538.94
|
| Rate for Payer: United Healthcare Commercial |
$14,399.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,220.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,978.51
|
| Rate for Payer: Zelis Medicare |
$18,681.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,829.67
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC
|
Facility
|
IP
|
$56,167.34
|
|
|
Service Code
|
MSDRG 939
|
| Min. Negotiated Rate |
$10,013.85 |
| Max. Negotiated Rate |
$56,167.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,013.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,709.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,013.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,939.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$33,039.61
|
| Rate for Payer: GEHA Medicare |
$33,039.61
|
| Rate for Payer: Humana ChoiceCare |
$36,343.57
|
| Rate for Payer: Humana Medicare Advantage |
$33,039.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$55,506.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,939.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$33,039.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$56,167.34
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$46,255.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,939.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$33,039.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$47,246.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$32,378.82
|
| Rate for Payer: United Healthcare Commercial |
$21,646.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,939.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,039.61
|
| Rate for Payer: Zelis Medicare |
$28,083.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,789.70
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC
|
Facility
|
IP
|
$34,583.42
|
|
|
Service Code
|
MSDRG 941
|
| Min. Negotiated Rate |
$4,277.70 |
| Max. Negotiated Rate |
$34,583.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,277.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,829.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,277.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,813.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,343.19
|
| Rate for Payer: GEHA Medicare |
$20,343.19
|
| Rate for Payer: Humana ChoiceCare |
$22,377.51
|
| Rate for Payer: Humana Medicare Advantage |
$20,343.19
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,176.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,813.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,343.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,583.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,480.47
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,813.24
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,343.19
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,090.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,936.33
|
| Rate for Payer: United Healthcare Commercial |
$13,328.33
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,813.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,343.19
|
| Rate for Payer: Zelis Medicare |
$17,291.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,800.67
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS
|
Facility
|
IP
|
$69,538.45
|
|
|
Service Code
|
MSDRG 876
|
| Min. Negotiated Rate |
$9,186.80 |
| Max. Negotiated Rate |
$69,538.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,186.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$31,829.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,186.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,479.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$40,904.97
|
| Rate for Payer: GEHA Medicare |
$40,904.97
|
| Rate for Payer: Humana ChoiceCare |
$44,995.47
|
| Rate for Payer: Humana Medicare Advantage |
$40,904.97
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$68,720.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,479.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$40,904.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$69,538.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57,266.96
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,479.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$40,904.97
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58,494.11
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$40,086.87
|
| Rate for Payer: United Healthcare Commercial |
$26,799.87
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,479.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40,904.97
|
| Rate for Payer: Zelis Medicare |
$34,769.22
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$25,738.88
|
|
|
MS-DRG 42.00: OSTEOMYELITIS WITH CC
|
Facility
|
IP
|
$22,900.50
|
|
|
Service Code
|
MSDRG 540
|
| Min. Negotiated Rate |
$6,910.75 |
| Max. Negotiated Rate |
$22,900.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,910.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,482.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,910.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,461.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,470.88
|
| Rate for Payer: GEHA Medicare |
$13,470.88
|
| Rate for Payer: Humana ChoiceCare |
$14,817.97
|
| Rate for Payer: Humana Medicare Advantage |
$13,470.88
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,631.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,461.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,470.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,900.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,859.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,461.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,470.88
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,263.36
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,201.46
|
| Rate for Payer: United Healthcare Commercial |
$8,825.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,461.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,470.88
|
| Rate for Payer: Zelis Medicare |
$11,450.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,476.35
|
|
|
MS-DRG 42.00: OSTEOMYELITIS WITH MCC
|
Facility
|
IP
|
$35,788.52
|
|
|
Service Code
|
MSDRG 539
|
| Min. Negotiated Rate |
$9,182.60 |
| Max. Negotiated Rate |
$35,788.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,182.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,381.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,182.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,472.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,052.07
|
| Rate for Payer: GEHA Medicare |
$21,052.07
|
| Rate for Payer: Humana ChoiceCare |
$23,157.28
|
| Rate for Payer: Humana Medicare Advantage |
$21,052.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$35,367.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,472.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,052.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,788.52
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,472.90
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,472.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,052.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$30,104.46
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,631.03
|
| Rate for Payer: United Healthcare Commercial |
$13,792.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,472.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,052.07
|
| Rate for Payer: Zelis Medicare |
$17,894.26
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,246.72
|
|
|
MS-DRG 42.00: OSTEOMYELITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$15,779.11
|
|
|
Service Code
|
MSDRG 541
|
| Min. Negotiated Rate |
$5,183.50 |
| Max. Negotiated Rate |
$15,779.11 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,183.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,086.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,183.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,412.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,281.83
|
| Rate for Payer: GEHA Medicare |
$9,281.83
|
| Rate for Payer: Humana ChoiceCare |
$10,210.01
|
| Rate for Payer: Humana Medicare Advantage |
$9,281.83
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,593.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,412.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,281.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,779.11
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,994.56
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,412.29
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,281.83
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,273.02
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,096.19
|
| Rate for Payer: United Healthcare Commercial |
$5,966.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,412.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,281.83
|
| Rate for Payer: Zelis Medicare |
$7,889.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,730.60
|
|
|
MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$22,792.53
|
|
|
Service Code
|
MSDRG 818
|
| Min. Negotiated Rate |
$3,639.65 |
| Max. Negotiated Rate |
$22,792.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,639.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,432.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,639.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,686.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,407.37
|
| Rate for Payer: GEHA Medicare |
$13,407.37
|
| Rate for Payer: Humana ChoiceCare |
$14,748.11
|
| Rate for Payer: Humana Medicare Advantage |
$13,407.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,524.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,686.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,407.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,792.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,770.32
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,686.87
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,407.37
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,172.54
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,139.22
|
| Rate for Payer: United Healthcare Commercial |
$8,784.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,686.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,407.37
|
| Rate for Payer: Zelis Medicare |
$11,396.26
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,436.40
|
|
|
MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$44,861.30
|
|
|
Service Code
|
MSDRG 817
|
| Min. Negotiated Rate |
$4,644.15 |
| Max. Negotiated Rate |
$44,861.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,644.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,534.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,644.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,460.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,389.00
|
| Rate for Payer: GEHA Medicare |
$26,389.00
|
| Rate for Payer: Humana ChoiceCare |
$29,027.90
|
| Rate for Payer: Humana Medicare Advantage |
$26,389.00
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$44,333.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,460.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,389.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$44,861.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$36,944.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,460.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,389.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37,736.27
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$25,861.22
|
| Rate for Payer: United Healthcare Commercial |
$17,289.38
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,460.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,389.00
|
| Rate for Payer: Zelis Medicare |
$22,430.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,604.90
|
|
|
MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$14,926.05
|
|
|
Service Code
|
MSDRG 819
|
| Min. Negotiated Rate |
$3,015.60 |
| Max. Negotiated Rate |
$14,926.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,015.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,613.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,015.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,585.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,780.03
|
| Rate for Payer: GEHA Medicare |
$8,780.03
|
| Rate for Payer: Humana ChoiceCare |
$9,658.03
|
| Rate for Payer: Humana Medicare Advantage |
$8,780.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,750.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,585.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,780.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,926.05
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,292.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,585.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,780.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,555.44
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,604.43
|
| Rate for Payer: United Healthcare Commercial |
$5,568.53
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,585.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,780.03
|
| Rate for Payer: Zelis Medicare |
$7,463.03
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,348.07
|
|
|
MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$13,916.68
|
|
|
Service Code
|
MSDRG 832
|
| Min. Negotiated Rate |
$1,926.05 |
| Max. Negotiated Rate |
$13,916.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,926.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,053.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,926.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,661.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,186.28
|
| Rate for Payer: GEHA Medicare |
$8,186.28
|
| Rate for Payer: Humana ChoiceCare |
$9,004.91
|
| Rate for Payer: Humana Medicare Advantage |
$8,186.28
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,752.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,661.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,186.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,916.68
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,460.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,661.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,186.28
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,706.38
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,022.55
|
| Rate for Payer: United Healthcare Commercial |
$5,097.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,661.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,186.28
|
| Rate for Payer: Zelis Medicare |
$6,958.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,895.47
|
|
|
MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$20,368.19
|
|
|
Service Code
|
MSDRG 831
|
| Min. Negotiated Rate |
$2,957.50 |
| Max. Negotiated Rate |
$20,368.19 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,957.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,323.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,957.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,482.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,981.29
|
| Rate for Payer: GEHA Medicare |
$11,981.29
|
| Rate for Payer: Humana ChoiceCare |
$13,179.42
|
| Rate for Payer: Humana Medicare Advantage |
$11,981.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,128.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,482.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,981.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,368.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,773.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,482.64
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,981.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,133.24
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,741.66
|
| Rate for Payer: United Healthcare Commercial |
$7,849.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,482.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,981.29
|
| Rate for Payer: Zelis Medicare |
$10,184.10
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,539.05
|
|
|
MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$10,591.97
|
|
|
Service Code
|
MSDRG 833
|
| Min. Negotiated Rate |
$1,357.30 |
| Max. Negotiated Rate |
$10,591.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,357.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,210.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,357.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,657.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,230.57
|
| Rate for Payer: GEHA Medicare |
$6,230.57
|
| Rate for Payer: Humana ChoiceCare |
$6,853.63
|
| Rate for Payer: Humana Medicare Advantage |
$6,230.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$10,467.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,657.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,230.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10,591.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8,722.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,657.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,230.57
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8,909.72
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,105.96
|
| Rate for Payer: United Healthcare Commercial |
$3,545.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,657.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,230.57
|
| Rate for Payer: Zelis Medicare |
$5,295.98
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,404.69
|
|
|
MS-DRG 42.00: OTHER CARDIOTHORACIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$88,184.83
|
|
|
Service Code
|
MSDRG 228
|
| Min. Negotiated Rate |
$31,240.30 |
| Max. Negotiated Rate |
$88,184.83 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$31,240.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40,364.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$31,240.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$55,411.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$51,873.43
|
| Rate for Payer: GEHA Medicare |
$51,873.43
|
| Rate for Payer: Humana ChoiceCare |
$57,060.77
|
| Rate for Payer: Humana Medicare Advantage |
$51,873.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$87,147.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$55,411.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$51,873.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$88,184.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$72,622.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$55,411.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$51,873.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$74,179.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$50,835.96
|
| Rate for Payer: United Healthcare Commercial |
$33,986.11
|
| Rate for Payer: United Healthcare Managed Medicaid |
$55,411.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$51,873.43
|
| Rate for Payer: Zelis Medicare |
$44,092.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$32,640.62
|
|
|
MS-DRG 42.00: OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$54,969.30
|
|
|
Service Code
|
MSDRG 229
|
| Min. Negotiated Rate |
$18,743.55 |
| Max. Negotiated Rate |
$54,969.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$18,743.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,161.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$18,743.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$33,350.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$32,334.88
|
| Rate for Payer: GEHA Medicare |
$32,334.88
|
| Rate for Payer: Humana ChoiceCare |
$35,568.37
|
| Rate for Payer: Humana Medicare Advantage |
$32,334.88
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$54,322.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$33,350.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$32,334.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$54,969.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$45,268.83
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$33,350.39
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$32,334.88
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$46,238.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$31,688.18
|
| Rate for Payer: United Healthcare Commercial |
$21,184.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$33,350.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,334.88
|
| Rate for Payer: Zelis Medicare |
$27,484.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,346.26
|
|
|
MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC
|
Facility
|
IP
|
$17,055.83
|
|
|
Service Code
|
MSDRG 315
|
| Min. Negotiated Rate |
$5,658.10 |
| Max. Negotiated Rate |
$17,055.83 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,658.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,794.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,658.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,250.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,032.84
|
| Rate for Payer: GEHA Medicare |
$10,032.84
|
| Rate for Payer: Humana ChoiceCare |
$11,036.12
|
| Rate for Payer: Humana Medicare Advantage |
$10,032.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,855.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,250.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,032.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,055.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,045.98
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,250.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,032.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,346.96
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,832.18
|
| Rate for Payer: United Healthcare Commercial |
$6,562.89
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,250.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,032.84
|
| Rate for Payer: Zelis Medicare |
$8,527.91
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,303.06
|
|
|
MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$38,108.49
|
|
|
Service Code
|
MSDRG 314
|
| Min. Negotiated Rate |
$7,628.25 |
| Max. Negotiated Rate |
$38,108.49 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,628.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,443.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,628.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,728.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,416.76
|
| Rate for Payer: GEHA Medicare |
$22,416.76
|
| Rate for Payer: Humana ChoiceCare |
$24,658.44
|
| Rate for Payer: Humana Medicare Advantage |
$22,416.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,660.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,728.10
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,416.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$38,108.49
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,383.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,728.10
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,416.76
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$32,055.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,968.42
|
| Rate for Payer: United Healthcare Commercial |
$14,686.87
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,728.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,416.76
|
| Rate for Payer: Zelis Medicare |
$19,054.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,105.42
|
|
|
MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$12,971.56
|
|
|
Service Code
|
MSDRG 316
|
| Min. Negotiated Rate |
$4,471.69 |
| Max. Negotiated Rate |
$12,971.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,643.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,529.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,643.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,224.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,630.33
|
| Rate for Payer: GEHA Medicare |
$7,630.33
|
| Rate for Payer: Humana ChoiceCare |
$8,393.36
|
| Rate for Payer: Humana Medicare Advantage |
$7,630.33
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,818.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,224.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,630.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,971.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,682.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,224.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,630.33
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,911.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,477.72
|
| Rate for Payer: United Healthcare Commercial |
$4,656.01
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,224.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,630.33
|
| Rate for Payer: Zelis Medicare |
$6,485.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,471.69
|
|
|
MS-DRG 42.00: OTHER CIRCULATORY SYSTEM O.R. PROCEDURES
|
Facility
|
IP
|
$61,849.55
|
|
|
Service Code
|
MSDRG 264
|
| Min. Negotiated Rate |
$9,835.70 |
| Max. Negotiated Rate |
$61,849.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,835.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$28,310.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,835.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$36,382.09
|
| Rate for Payer: GEHA Medicare |
$36,382.09
|
| Rate for Payer: Humana ChoiceCare |
$40,020.30
|
| Rate for Payer: Humana Medicare Advantage |
$36,382.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$61,121.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,625.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$36,382.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$61,849.55
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$50,934.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,625.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$36,382.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$52,026.39
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$35,654.45
|
| Rate for Payer: United Healthcare Commercial |
$23,836.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,625.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,382.09
|
| Rate for Payer: Zelis Medicare |
$30,924.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,892.90
|
|
|
MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC
|
Facility
|
IP
|
$16,749.08
|
|
|
Service Code
|
MSDRG 394
|
| Min. Negotiated Rate |
$3,519.25 |
| Max. Negotiated Rate |
$16,749.08 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,519.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,624.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,519.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,474.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,852.40
|
| Rate for Payer: GEHA Medicare |
$9,852.40
|
| Rate for Payer: Humana ChoiceCare |
$10,837.64
|
| Rate for Payer: Humana Medicare Advantage |
$9,852.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,552.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,474.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,852.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,749.08
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,793.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,474.32
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,852.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,088.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,655.35
|
| Rate for Payer: United Healthcare Commercial |
$6,419.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,474.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,852.40
|
| Rate for Payer: Zelis Medicare |
$8,374.54
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,165.52
|
|
|
MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$29,304.69
|
|
|
Service Code
|
MSDRG 393
|
| Min. Negotiated Rate |
$4,632.95 |
| Max. Negotiated Rate |
$29,304.69 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,632.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,413.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,632.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,440.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,238.05
|
| Rate for Payer: GEHA Medicare |
$17,238.05
|
| Rate for Payer: Humana ChoiceCare |
$18,961.85
|
| Rate for Payer: Humana Medicare Advantage |
$17,238.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,959.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,440.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,238.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,304.69
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,133.27
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,440.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,238.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,650.41
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,893.29
|
| Rate for Payer: United Healthcare Commercial |
$11,293.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,440.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,238.05
|
| Rate for Payer: Zelis Medicare |
$14,652.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,846.80
|
|
|
MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$12,295.23
|
|
|
Service Code
|
MSDRG 395
|
| Min. Negotiated Rate |
$2,988.30 |
| Max. Negotiated Rate |
$12,295.23 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,988.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,154.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,988.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,537.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,232.49
|
| Rate for Payer: GEHA Medicare |
$7,232.49
|
| Rate for Payer: Humana ChoiceCare |
$7,955.74
|
| Rate for Payer: Humana Medicare Advantage |
$7,232.49
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,150.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,537.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,232.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,295.23
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,125.49
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,537.02
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,232.49
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,342.46
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,087.84
|
| Rate for Payer: United Healthcare Commercial |
$4,340.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,537.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,232.49
|
| Rate for Payer: Zelis Medicare |
$6,147.62
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,168.42
|
|
|
MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$39,851.55
|
|
|
Service Code
|
MSDRG 357
|
| Min. Negotiated Rate |
$12,088.65 |
| Max. Negotiated Rate |
$39,851.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,088.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,241.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,088.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21,602.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,442.09
|
| Rate for Payer: GEHA Medicare |
$23,442.09
|
| Rate for Payer: Humana ChoiceCare |
$25,786.30
|
| Rate for Payer: Humana Medicare Advantage |
$23,442.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,382.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21,602.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,442.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39,851.55
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,818.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21,602.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,442.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,522.19
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,973.25
|
| Rate for Payer: United Healthcare Commercial |
$15,358.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21,602.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,442.09
|
| Rate for Payer: Zelis Medicare |
$19,925.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,750.60
|
|
