|
MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$75,486.14
|
|
|
Service Code
|
MSDRG 356
|
| Min. Negotiated Rate |
$20,690.25 |
| Max. Negotiated Rate |
$75,486.14 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$20,690.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$34,552.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$20,690.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$36,786.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$44,403.61
|
| Rate for Payer: GEHA Medicare |
$44,403.61
|
| Rate for Payer: Humana ChoiceCare |
$48,843.97
|
| Rate for Payer: Humana Medicare Advantage |
$44,403.61
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$74,598.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$36,786.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$44,403.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$75,486.14
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$62,165.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$36,786.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$44,403.61
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$63,497.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$43,515.54
|
| Rate for Payer: United Healthcare Commercial |
$29,092.07
|
| Rate for Payer: United Healthcare Managed Medicaid |
$36,786.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$44,403.61
|
| Rate for Payer: Zelis Medicare |
$37,743.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$27,940.33
|
|
|
MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$23,979.94
|
|
|
Service Code
|
MSDRG 358
|
| Min. Negotiated Rate |
$6,700.40 |
| Max. Negotiated Rate |
$23,979.94 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,700.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,976.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,700.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,090.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,105.85
|
| Rate for Payer: GEHA Medicare |
$14,105.85
|
| Rate for Payer: Humana ChoiceCare |
$15,516.43
|
| Rate for Payer: Humana Medicare Advantage |
$14,105.85
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,697.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,090.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,105.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,979.94
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,748.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,090.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,105.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,171.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,823.73
|
| Rate for Payer: United Healthcare Commercial |
$9,241.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,090.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,105.85
|
| Rate for Payer: Zelis Medicare |
$11,989.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,875.91
|
|
|
MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITH CC
|
Facility
|
IP
|
$18,734.85
|
|
|
Service Code
|
MSDRG 092
|
| Min. Negotiated Rate |
$4,192.30 |
| Max. Negotiated Rate |
$18,734.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,192.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,575.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,192.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,662.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,020.50
|
| Rate for Payer: GEHA Medicare |
$11,020.50
|
| Rate for Payer: Humana ChoiceCare |
$12,122.55
|
| Rate for Payer: Humana Medicare Advantage |
$11,020.50
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,514.44
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,662.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,020.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,734.85
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,428.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,662.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,020.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,759.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,800.09
|
| Rate for Payer: United Healthcare Commercial |
$7,220.33
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,662.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,020.50
|
| Rate for Payer: Zelis Medicare |
$9,367.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,934.48
|
|
|
MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC
|
Facility
|
IP
|
$32,258.16
|
|
|
Service Code
|
MSDRG 091
|
| Min. Negotiated Rate |
$5,701.50 |
| Max. Negotiated Rate |
$32,258.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,701.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,765.49
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,701.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,326.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,975.39
|
| Rate for Payer: GEHA Medicare |
$18,975.39
|
| Rate for Payer: Humana ChoiceCare |
$20,872.93
|
| Rate for Payer: Humana Medicare Advantage |
$18,975.39
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,878.66
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,326.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,975.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,258.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,565.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,326.74
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,975.39
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,134.81
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,595.88
|
| Rate for Payer: United Healthcare Commercial |
$12,432.18
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,326.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,975.39
|
| Rate for Payer: Zelis Medicare |
$16,129.08
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,940.00
|
|
|
MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$14,528.71
|
|
|
Service Code
|
MSDRG 093
|
| Min. Negotiated Rate |
$3,719.10 |
| Max. Negotiated Rate |
$14,528.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,719.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,393.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,719.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,827.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,546.30
|
| Rate for Payer: GEHA Medicare |
$8,546.30
|
| Rate for Payer: Humana ChoiceCare |
$9,400.93
|
| Rate for Payer: Humana Medicare Advantage |
$8,546.30
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,357.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,827.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,546.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,528.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,964.82
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,827.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,546.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,221.21
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,375.37
|
| Rate for Payer: United Healthcare Commercial |
$5,383.03
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,827.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,546.30
|
| Rate for Payer: Zelis Medicare |
$7,264.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,169.91
|
|
|
MS-DRG 42.00: OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT
|
Facility
|
IP
|
$23,073.90
|
|
|
Service Code
|
MSDRG 124
|
| Min. Negotiated Rate |
$3,499.65 |
| Max. Negotiated Rate |
$23,073.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,499.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,561.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,499.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,439.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,572.88
|
| Rate for Payer: GEHA Medicare |
$13,572.88
|
| Rate for Payer: Humana ChoiceCare |
$14,930.17
|
| Rate for Payer: Humana Medicare Advantage |
$13,572.88
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,802.44
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,439.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,572.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,073.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,002.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,439.72
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,572.88
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,409.22
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,301.42
|
| Rate for Payer: United Healthcare Commercial |
$8,892.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,439.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,572.88
|
| Rate for Payer: Zelis Medicare |
$11,536.95
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,540.55
|
|
|
MS-DRG 42.00: OTHER DISORDERS OF THE EYE WITHOUT MCC
|
Facility
|
IP
|
$15,060.44
|
|
|
Service Code
|
MSDRG 125
|
| Min. Negotiated Rate |
$2,120.30 |
| Max. Negotiated Rate |
$15,060.44 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,120.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,688.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,120.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,004.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,859.08
|
| Rate for Payer: GEHA Medicare |
$8,859.08
|
| Rate for Payer: Humana ChoiceCare |
$9,744.99
|
| Rate for Payer: Humana Medicare Advantage |
$8,859.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,883.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,004.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,859.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,060.44
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,402.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,004.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,859.08
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,668.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,681.90
|
| Rate for Payer: United Healthcare Commercial |
$5,631.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,004.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,859.08
|
| Rate for Payer: Zelis Medicare |
$7,530.22
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,408.34
|
|
|
MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC
|
Facility
|
IP
|
$16,636.62
|
|
|
Service Code
|
MSDRG 155
|
| Min. Negotiated Rate |
$3,041.85 |
| Max. Negotiated Rate |
$16,636.62 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,041.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,562.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,041.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,631.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,786.25
|
| Rate for Payer: GEHA Medicare |
$9,786.25
|
| Rate for Payer: Humana ChoiceCare |
$10,764.88
|
| Rate for Payer: Humana Medicare Advantage |
$9,786.25
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,440.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,631.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,786.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,636.62
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,700.75
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,631.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,786.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,994.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,590.52
|
| Rate for Payer: United Healthcare Commercial |
$6,367.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,631.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,786.25
|
| Rate for Payer: Zelis Medicare |
$8,318.31
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,115.08
|
|
|
MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC
|
Facility
|
IP
|
$28,779.11
|
|
|
Service Code
|
MSDRG 154
|
| Min. Negotiated Rate |
$4,134.20 |
| Max. Negotiated Rate |
$28,779.11 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,134.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,173.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,134.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,559.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,928.89
|
| Rate for Payer: GEHA Medicare |
$16,928.89
|
| Rate for Payer: Humana ChoiceCare |
$18,621.78
|
| Rate for Payer: Humana Medicare Advantage |
$16,928.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,440.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,559.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,928.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,779.11
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,700.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,559.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,928.89
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,208.31
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,590.31
|
| Rate for Payer: United Healthcare Commercial |
$11,091.37
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,559.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,928.89
|
| Rate for Payer: Zelis Medicare |
$14,389.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,652.26
|
|
|
MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$12,821.13
|
|
|
Service Code
|
MSDRG 156
|
| Min. Negotiated Rate |
$2,489.55 |
| Max. Negotiated Rate |
$12,821.13 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,489.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,446.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,489.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,656.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,541.84
|
| Rate for Payer: GEHA Medicare |
$7,541.84
|
| Rate for Payer: Humana ChoiceCare |
$8,296.02
|
| Rate for Payer: Humana Medicare Advantage |
$7,541.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,670.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,656.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,541.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,821.13
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,558.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,656.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,541.84
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,784.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,391.00
|
| Rate for Payer: United Healthcare Commercial |
$4,585.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,656.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,541.84
|
| Rate for Payer: Zelis Medicare |
$6,410.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,404.22
|
|
|
MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$31,086.69
|
|
|
Service Code
|
MSDRG 144
|
| Min. Negotiated Rate |
$4,084.15 |
| Max. Negotiated Rate |
$31,086.69 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,084.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,229.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,084.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,471.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,286.29
|
| Rate for Payer: GEHA Medicare |
$18,286.29
|
| Rate for Payer: Humana ChoiceCare |
$20,114.92
|
| Rate for Payer: Humana Medicare Advantage |
$18,286.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,720.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,471.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,286.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,086.69
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,600.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,471.56
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,286.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,149.39
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,920.56
|
| Rate for Payer: United Healthcare Commercial |
$11,980.69
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,471.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,286.29
|
| Rate for Payer: Zelis Medicare |
$15,543.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,506.39
|
|
|
MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$58,430.67
|
|
|
Service Code
|
MSDRG 143
|
| Min. Negotiated Rate |
$6,797.00 |
| Max. Negotiated Rate |
$58,430.67 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,797.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$26,745.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,797.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,260.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$34,370.98
|
| Rate for Payer: GEHA Medicare |
$34,370.98
|
| Rate for Payer: Humana ChoiceCare |
$37,808.08
|
| Rate for Payer: Humana Medicare Advantage |
$34,370.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$57,743.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,260.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$34,370.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$58,430.67
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$48,119.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,260.67
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$34,370.98
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$49,150.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$33,683.56
|
| Rate for Payer: United Healthcare Commercial |
$22,518.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,260.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34,370.98
|
| Rate for Payer: Zelis Medicare |
$29,215.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21,627.44
|
|
|
MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,966.34
|
|
|
Service Code
|
MSDRG 145
|
| Min. Negotiated Rate |
$2,523.50 |
| Max. Negotiated Rate |
$20,966.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,523.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,596.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,523.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,716.49
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,333.14
|
| Rate for Payer: GEHA Medicare |
$12,333.14
|
| Rate for Payer: Humana ChoiceCare |
$13,566.45
|
| Rate for Payer: Humana Medicare Advantage |
$12,333.14
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,719.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,716.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,333.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,966.34
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,266.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,716.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,333.14
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,636.39
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,086.48
|
| Rate for Payer: United Healthcare Commercial |
$8,080.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,716.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,333.14
|
| Rate for Payer: Zelis Medicare |
$10,483.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,760.44
|
|
|
MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$39,800.23
|
|
|
Service Code
|
MSDRG 629
|
| Min. Negotiated Rate |
$8,811.25 |
| Max. Negotiated Rate |
$39,800.23 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,811.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,217.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,811.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,816.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,411.90
|
| Rate for Payer: GEHA Medicare |
$23,411.90
|
| Rate for Payer: Humana ChoiceCare |
$25,753.09
|
| Rate for Payer: Humana Medicare Advantage |
$23,411.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,331.99
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,816.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,411.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39,800.23
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,776.66
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,816.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,411.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,479.02
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,943.66
|
| Rate for Payer: United Healthcare Commercial |
$15,338.86
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,816.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,411.90
|
| Rate for Payer: Zelis Medicare |
$19,900.12
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,731.60
|
|
|
MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$69,823.37
|
|
|
Service Code
|
MSDRG 628
|
| Min. Negotiated Rate |
$15,192.10 |
| Max. Negotiated Rate |
$69,823.37 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15,192.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$31,960.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15,192.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$27,080.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$41,072.57
|
| Rate for Payer: GEHA Medicare |
$41,072.57
|
| Rate for Payer: Humana ChoiceCare |
$45,179.83
|
| Rate for Payer: Humana Medicare Advantage |
$41,072.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$69,001.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$27,080.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$41,072.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$69,823.37
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57,501.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$27,080.87
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$41,072.57
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58,733.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$40,251.12
|
| Rate for Payer: United Healthcare Commercial |
$26,909.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$27,080.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41,072.57
|
| Rate for Payer: Zelis Medicare |
$34,911.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$25,844.33
|
|
|
MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,797.51
|
|
|
Service Code
|
MSDRG 630
|
| Min. Negotiated Rate |
$5,545.75 |
| Max. Negotiated Rate |
$24,797.51 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,545.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,350.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,545.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,051.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,586.77
|
| Rate for Payer: GEHA Medicare |
$14,586.77
|
| Rate for Payer: Humana ChoiceCare |
$16,045.45
|
| Rate for Payer: Humana Medicare Advantage |
$14,586.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,505.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,051.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,586.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,797.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,421.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,051.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,586.77
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,859.08
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,295.03
|
| Rate for Payer: United Healthcare Commercial |
$9,556.87
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,051.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,586.77
|
| Rate for Payer: Zelis Medicare |
$12,398.75
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,178.51
|
|
|
MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC
|
Facility
|
IP
|
$77,735.30
|
|
|
Service Code
|
MSDRG 319
|
| Min. Negotiated Rate |
$28,772.84 |
| Max. Negotiated Rate |
$77,735.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$37,241.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$35,581.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$37,241.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$66,004.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$45,726.65
|
| Rate for Payer: GEHA Medicare |
$45,726.65
|
| Rate for Payer: Humana ChoiceCare |
$50,299.32
|
| Rate for Payer: Humana Medicare Advantage |
$45,726.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$76,820.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$66,004.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$45,726.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$77,735.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$64,017.31
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$66,004.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$45,726.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$65,389.11
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$44,812.12
|
| Rate for Payer: United Healthcare Commercial |
$29,958.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$66,004.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45,726.65
|
| Rate for Payer: Zelis Medicare |
$38,867.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$28,772.84
|
|
|
MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$48,910.80
|
|
|
Service Code
|
MSDRG 320
|
| Min. Negotiated Rate |
$15,161.94 |
| Max. Negotiated Rate |
$48,910.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27,557.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,749.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27,557.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48,910.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,095.81
|
| Rate for Payer: GEHA Medicare |
$24,095.81
|
| Rate for Payer: Humana ChoiceCare |
$26,505.39
|
| Rate for Payer: Humana Medicare Advantage |
$24,095.81
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$40,480.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$48,910.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,095.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40,962.88
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$33,734.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$48,910.80
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,095.81
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$34,457.01
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,613.89
|
| Rate for Payer: United Healthcare Commercial |
$15,786.94
|
| Rate for Payer: United Healthcare Managed Medicaid |
$48,910.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,095.81
|
| Rate for Payer: Zelis Medicare |
$20,481.44
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,161.94
|
|
|
MS-DRG 42.00: OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$11,281.47
|
|
|
Service Code
|
MSDRG 951
|
| Min. Negotiated Rate |
$1,611.05 |
| Max. Negotiated Rate |
$11,281.47 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,611.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,592.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,611.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,105.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,636.16
|
| Rate for Payer: GEHA Medicare |
$6,636.16
|
| Rate for Payer: Humana ChoiceCare |
$7,299.78
|
| Rate for Payer: Humana Medicare Advantage |
$6,636.16
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,148.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,105.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,636.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,281.47
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9,290.62
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,105.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,636.16
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9,489.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,503.44
|
| Rate for Payer: United Healthcare Commercial |
$3,866.94
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,105.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,636.16
|
| Rate for Payer: Zelis Medicare |
$5,640.74
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,713.85
|
|
|
MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$45,808.03
|
|
|
Service Code
|
MSDRG 749
|
| Min. Negotiated Rate |
$8,669.85 |
| Max. Negotiated Rate |
$45,808.03 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,669.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,967.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,669.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,566.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,945.90
|
| Rate for Payer: GEHA Medicare |
$26,945.90
|
| Rate for Payer: Humana ChoiceCare |
$29,640.49
|
| Rate for Payer: Humana Medicare Advantage |
$26,945.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$45,269.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,566.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,945.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$45,808.03
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$37,724.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,566.88
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,945.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$38,532.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$26,406.98
|
| Rate for Payer: United Healthcare Commercial |
$17,654.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,566.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,945.90
|
| Rate for Payer: Zelis Medicare |
$22,904.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,955.33
|
|
|
MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,819.10
|
|
|
Service Code
|
MSDRG 750
|
| Min. Negotiated Rate |
$6,151.60 |
| Max. Negotiated Rate |
$22,819.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,151.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,444.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,151.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,121.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,423.00
|
| Rate for Payer: GEHA Medicare |
$13,423.00
|
| Rate for Payer: Humana ChoiceCare |
$14,765.30
|
| Rate for Payer: Humana Medicare Advantage |
$13,423.00
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,550.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,121.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,423.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,819.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,792.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,121.32
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,423.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,194.89
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,154.54
|
| Rate for Payer: United Healthcare Commercial |
$8,794.39
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,121.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,423.00
|
| Rate for Payer: Zelis Medicare |
$11,409.55
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,446.23
|
|
|
MS-DRG 42.00: OTHER HEART ASSIST SYSTEM IMPLANT
|
Facility
|
IP
|
$187,486.34
|
|
|
Service Code
|
MSDRG 215
|
| Min. Negotiated Rate |
$46,424.70 |
| Max. Negotiated Rate |
$187,486.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$46,424.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$85,817.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$46,424.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$82,217.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$110,286.08
|
| Rate for Payer: GEHA Medicare |
$110,286.08
|
| Rate for Payer: Humana ChoiceCare |
$121,314.69
|
| Rate for Payer: Humana Medicare Advantage |
$110,286.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$185,280.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$82,217.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$110,286.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$187,486.34
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$154,400.51
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$82,217.03
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$110,286.08
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$157,709.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$108,080.36
|
| Rate for Payer: United Healthcare Commercial |
$72,256.54
|
| Rate for Payer: United Healthcare Managed Medicaid |
$82,217.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110,286.08
|
| Rate for Payer: Zelis Medicare |
$93,743.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$69,395.94
|
|
|
MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$40,405.46
|
|
|
Service Code
|
MSDRG 424
|
| Min. Negotiated Rate |
$13,520.15 |
| Max. Negotiated Rate |
$40,405.46 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$13,520.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,494.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$13,520.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$24,129.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,767.92
|
| Rate for Payer: GEHA Medicare |
$23,767.92
|
| Rate for Payer: Humana ChoiceCare |
$26,144.71
|
| Rate for Payer: Humana Medicare Advantage |
$23,767.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,930.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$24,129.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,767.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40,405.46
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$33,275.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$24,129.31
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,767.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,988.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,292.56
|
| Rate for Payer: United Healthcare Commercial |
$15,572.11
|
| Rate for Payer: United Healthcare Managed Medicaid |
$24,129.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,767.92
|
| Rate for Payer: Zelis Medicare |
$20,202.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,955.61
|
|
|
MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$71,976.98
|
|
|
Service Code
|
MSDRG 423
|
| Min. Negotiated Rate |
$20,098.05 |
| Max. Negotiated Rate |
$71,976.98 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$20,098.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$32,945.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$20,098.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$35,741.54
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$42,339.40
|
| Rate for Payer: GEHA Medicare |
$42,339.40
|
| Rate for Payer: Humana ChoiceCare |
$46,573.34
|
| Rate for Payer: Humana Medicare Advantage |
$42,339.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$71,130.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$35,741.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$42,339.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$71,976.98
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$59,275.16
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$35,741.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$42,339.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$60,545.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$41,492.61
|
| Rate for Payer: United Healthcare Commercial |
$27,739.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$35,741.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42,339.40
|
| Rate for Payer: Zelis Medicare |
$35,988.49
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$26,641.47
|
|
|
MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$27,354.56
|
|
|
Service Code
|
MSDRG 425
|
| Min. Negotiated Rate |
$10,124.99 |
| Max. Negotiated Rate |
$27,354.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,667.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,520.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,667.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,093.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,090.92
|
| Rate for Payer: GEHA Medicare |
$16,090.92
|
| Rate for Payer: Humana ChoiceCare |
$17,700.01
|
| Rate for Payer: Humana Medicare Advantage |
$16,090.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,032.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,093.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,090.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,354.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,527.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,093.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,090.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,010.02
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,769.10
|
| Rate for Payer: United Healthcare Commercial |
$10,542.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,093.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,090.92
|
| Rate for Payer: Zelis Medicare |
$13,677.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,124.99
|
|
