|
MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC
|
Facility
|
IP
|
$27,768.68
|
|
|
Service Code
|
MSDRG 564
|
| Min. Negotiated Rate |
$5,393.50 |
| Max. Negotiated Rate |
$27,768.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,393.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,710.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,393.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,783.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,334.52
|
| Rate for Payer: GEHA Medicare |
$16,334.52
|
| Rate for Payer: Humana ChoiceCare |
$17,967.97
|
| Rate for Payer: Humana Medicare Advantage |
$16,334.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,441.99
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,783.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,334.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,768.68
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,868.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,783.01
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,334.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,358.36
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,007.83
|
| Rate for Payer: United Healthcare Commercial |
$10,701.94
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,783.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,334.52
|
| Rate for Payer: Zelis Medicare |
$13,884.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,278.26
|
|
|
MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$13,926.91
|
|
|
Service Code
|
MSDRG 566
|
| Min. Negotiated Rate |
$2,337.65 |
| Max. Negotiated Rate |
$13,926.91 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,337.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,059.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,337.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,388.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,192.30
|
| Rate for Payer: GEHA Medicare |
$8,192.30
|
| Rate for Payer: Humana ChoiceCare |
$9,011.53
|
| Rate for Payer: Humana Medicare Advantage |
$8,192.30
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,763.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,388.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,192.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,926.91
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,469.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,388.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,192.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,714.99
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,028.45
|
| Rate for Payer: United Healthcare Commercial |
$5,102.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,388.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,192.30
|
| Rate for Payer: Zelis Medicare |
$6,963.45
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,900.06
|
|
|
MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$35,599.19
|
|
|
Service Code
|
MSDRG 516
|
| Min. Negotiated Rate |
$8,952.30 |
| Max. Negotiated Rate |
$35,599.19 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,952.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,294.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,952.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,065.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,940.70
|
| Rate for Payer: GEHA Medicare |
$20,940.70
|
| Rate for Payer: Humana ChoiceCare |
$23,034.77
|
| Rate for Payer: Humana Medicare Advantage |
$20,940.70
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$35,180.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,065.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,940.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,599.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,316.98
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,065.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,940.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,945.20
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,521.89
|
| Rate for Payer: United Healthcare Commercial |
$13,719.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,065.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,940.70
|
| Rate for Payer: Zelis Medicare |
$17,799.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,176.64
|
|
|
MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$54,723.34
|
|
|
Service Code
|
MSDRG 515
|
| Min. Negotiated Rate |
$16,579.85 |
| Max. Negotiated Rate |
$54,723.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,579.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,048.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,579.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$29,530.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$32,190.20
|
| Rate for Payer: GEHA Medicare |
$32,190.20
|
| Rate for Payer: Humana ChoiceCare |
$35,409.22
|
| Rate for Payer: Humana Medicare Advantage |
$32,190.20
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$54,079.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$29,530.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$32,190.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$54,723.34
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$45,066.28
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$29,530.72
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$32,190.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$46,031.99
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$31,546.40
|
| Rate for Payer: United Healthcare Commercial |
$21,090.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$29,530.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,190.20
|
| Rate for Payer: Zelis Medicare |
$27,361.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,255.22
|
|
|
MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$26,414.91
|
|
|
Service Code
|
MSDRG 517
|
| Min. Negotiated Rate |
$5,953.15 |
| Max. Negotiated Rate |
$26,414.91 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,953.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,090.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,953.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,770.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,538.18
|
| Rate for Payer: GEHA Medicare |
$15,538.18
|
| Rate for Payer: Humana ChoiceCare |
$17,092.00
|
| Rate for Payer: Humana Medicare Advantage |
$15,538.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,104.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,770.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,538.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,414.91
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,753.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,770.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,538.18
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,219.60
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,227.42
|
| Rate for Payer: United Healthcare Commercial |
$10,180.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,770.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,538.18
|
| Rate for Payer: Zelis Medicare |
$13,207.45
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,777.18
|
|
|
MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC
|
Facility
|
IP
|
$21,150.35
|
|
|
Service Code
|
MSDRG 844
|
| Min. Negotiated Rate |
$7,324.45 |
| Max. Negotiated Rate |
$21,150.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,324.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,681.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,324.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,191.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,441.38
|
| Rate for Payer: GEHA Medicare |
$12,441.38
|
| Rate for Payer: Humana ChoiceCare |
$13,685.52
|
| Rate for Payer: Humana Medicare Advantage |
$12,441.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,901.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,191.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,441.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,150.35
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,417.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,191.79
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,441.38
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,791.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,192.55
|
| Rate for Payer: United Healthcare Commercial |
$8,151.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,191.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,441.38
|
| Rate for Payer: Zelis Medicare |
$10,575.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,828.56
|
|
|
MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC
|
Facility
|
IP
|
$33,503.99
|
|
|
Service Code
|
MSDRG 843
|
| Min. Negotiated Rate |
$12,401.11 |
| Max. Negotiated Rate |
$33,503.99 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,445.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,335.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,445.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22,231.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,708.23
|
| Rate for Payer: GEHA Medicare |
$19,708.23
|
| Rate for Payer: Humana ChoiceCare |
$21,679.05
|
| Rate for Payer: Humana Medicare Advantage |
$19,708.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$33,109.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22,231.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,708.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$33,503.99
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,591.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22,231.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,708.23
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,182.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,314.07
|
| Rate for Payer: United Healthcare Commercial |
$12,912.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22,231.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,708.23
|
| Rate for Payer: Zelis Medicare |
$16,752.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,401.11
|
|
|
MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$15,222.58
|
|
|
Service Code
|
MSDRG 845
|
| Min. Negotiated Rate |
$3,724.35 |
| Max. Negotiated Rate |
$15,222.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,724.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,778.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,724.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,836.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,954.46
|
| Rate for Payer: GEHA Medicare |
$8,954.46
|
| Rate for Payer: Humana ChoiceCare |
$9,849.91
|
| Rate for Payer: Humana Medicare Advantage |
$8,954.46
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,043.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,836.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,954.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,222.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,536.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,836.39
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,954.46
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,804.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,775.37
|
| Rate for Payer: United Healthcare Commercial |
$5,706.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,836.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,954.46
|
| Rate for Payer: Zelis Medicare |
$7,611.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,481.04
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITH CC
|
Facility
|
IP
|
$35,694.75
|
|
|
Service Code
|
MSDRG 908
|
| Min. Negotiated Rate |
$7,163.80 |
| Max. Negotiated Rate |
$35,694.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,163.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,338.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,163.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,908.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,996.91
|
| Rate for Payer: GEHA Medicare |
$20,996.91
|
| Rate for Payer: Humana ChoiceCare |
$23,096.60
|
| Rate for Payer: Humana Medicare Advantage |
$20,996.91
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$35,274.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,908.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,996.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,694.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,395.67
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,908.19
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,996.91
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$30,025.58
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,576.97
|
| Rate for Payer: United Healthcare Commercial |
$13,756.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,908.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,996.91
|
| Rate for Payer: Zelis Medicare |
$17,847.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,212.00
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITH MCC
|
Facility
|
IP
|
$70,495.84
|
|
|
Service Code
|
MSDRG 907
|
| Min. Negotiated Rate |
$16,255.05 |
| Max. Negotiated Rate |
$70,495.84 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,255.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$32,267.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,255.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$28,957.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$41,468.14
|
| Rate for Payer: GEHA Medicare |
$41,468.14
|
| Rate for Payer: Humana ChoiceCare |
$45,614.95
|
| Rate for Payer: Humana Medicare Advantage |
$41,468.14
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$69,666.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$28,957.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$41,468.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$70,495.84
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$58,055.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$28,957.34
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$41,468.14
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$59,299.44
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$40,638.78
|
| Rate for Payer: United Healthcare Commercial |
$27,168.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$28,957.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41,468.14
|
| Rate for Payer: Zelis Medicare |
$35,247.92
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$26,093.24
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,443.93
|
|
|
Service Code
|
MSDRG 909
|
| Min. Negotiated Rate |
$4,267.55 |
| Max. Negotiated Rate |
$22,443.93 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,267.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,273.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,267.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,795.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,202.31
|
| Rate for Payer: GEHA Medicare |
$13,202.31
|
| Rate for Payer: Humana ChoiceCare |
$14,522.54
|
| Rate for Payer: Humana Medicare Advantage |
$13,202.31
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,179.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,795.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,202.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,443.93
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,483.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,795.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,202.31
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,879.30
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,938.26
|
| Rate for Payer: United Healthcare Commercial |
$8,649.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,795.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,202.31
|
| Rate for Payer: Zelis Medicare |
$11,221.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,307.36
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC
|
Facility
|
IP
|
$72,727.33
|
|
|
Service Code
|
MSDRG 958
|
| Min. Negotiated Rate |
$22,800.40 |
| Max. Negotiated Rate |
$72,727.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$22,800.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33,289.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$22,800.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$40,512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$42,780.78
|
| Rate for Payer: GEHA Medicare |
$42,780.78
|
| Rate for Payer: Humana ChoiceCare |
$47,058.86
|
| Rate for Payer: Humana Medicare Advantage |
$42,780.78
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$71,871.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$40,512.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$42,780.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$72,727.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$59,893.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$40,512.11
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$42,780.78
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$61,176.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$41,925.16
|
| Rate for Payer: United Healthcare Commercial |
$28,028.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$40,512.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42,780.78
|
| Rate for Payer: Zelis Medicare |
$36,363.66
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$26,919.19
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$132,087.01
|
|
|
Service Code
|
MSDRG 957
|
| Min. Negotiated Rate |
$30,487.80 |
| Max. Negotiated Rate |
$132,087.01 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$30,487.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$60,460.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$30,487.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$54,082.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$77,698.24
|
| Rate for Payer: GEHA Medicare |
$77,698.24
|
| Rate for Payer: Humana ChoiceCare |
$85,468.06
|
| Rate for Payer: Humana Medicare Advantage |
$77,698.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$130,533.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$54,082.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$77,698.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$132,087.01
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$108,777.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$54,082.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$77,698.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$111,108.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$76,144.28
|
| Rate for Payer: United Healthcare Commercial |
$50,905.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$54,082.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$77,698.24
|
| Rate for Payer: Zelis Medicare |
$66,043.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$48,890.51
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$46,786.65
|
|
|
Service Code
|
MSDRG 959
|
| Min. Negotiated Rate |
$17,317.54 |
| Max. Negotiated Rate |
$46,786.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$17,432.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21,415.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$17,432.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$31,035.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$27,521.56
|
| Rate for Payer: GEHA Medicare |
$27,521.56
|
| Rate for Payer: Humana ChoiceCare |
$30,273.72
|
| Rate for Payer: Humana Medicare Advantage |
$27,521.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$46,236.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$31,035.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$27,521.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46,786.65
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$38,530.18
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$31,035.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$27,521.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$39,355.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$26,971.13
|
| Rate for Payer: United Healthcare Commercial |
$18,031.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$31,035.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,521.56
|
| Rate for Payer: Zelis Medicare |
$23,393.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,317.54
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC
|
Facility
|
IP
|
$31,499.01
|
|
|
Service Code
|
MSDRG 803
|
| Min. Negotiated Rate |
$8,691.55 |
| Max. Negotiated Rate |
$31,499.01 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,691.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,418.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,691.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,605.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,528.83
|
| Rate for Payer: GEHA Medicare |
$18,528.83
|
| Rate for Payer: Humana ChoiceCare |
$20,381.71
|
| Rate for Payer: Humana Medicare Advantage |
$18,528.83
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,128.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,605.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,528.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,499.01
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,940.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,605.19
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,528.83
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,496.23
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,158.25
|
| Rate for Payer: United Healthcare Commercial |
$12,139.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,605.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,528.83
|
| Rate for Payer: Zelis Medicare |
$15,749.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,659.00
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC
|
Facility
|
IP
|
$63,436.86
|
|
|
Service Code
|
MSDRG 802
|
| Min. Negotiated Rate |
$17,334.80 |
| Max. Negotiated Rate |
$63,436.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$17,334.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$29,036.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$17,334.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$30,863.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$37,315.80
|
| Rate for Payer: GEHA Medicare |
$37,315.80
|
| Rate for Payer: Humana ChoiceCare |
$41,047.38
|
| Rate for Payer: Humana Medicare Advantage |
$37,315.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$62,690.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$30,863.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$37,315.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$63,436.86
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$52,242.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$30,863.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$37,315.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$53,361.59
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$36,569.48
|
| Rate for Payer: United Healthcare Commercial |
$24,448.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$30,863.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37,315.80
|
| Rate for Payer: Zelis Medicare |
$31,718.43
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23,480.44
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC
|
Facility
|
IP
|
$19,564.76
|
|
|
Service Code
|
MSDRG 804
|
| Min. Negotiated Rate |
$7,203.35 |
| Max. Negotiated Rate |
$19,564.76 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,203.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,955.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,203.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,978.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,508.68
|
| Rate for Payer: GEHA Medicare |
$11,508.68
|
| Rate for Payer: Humana ChoiceCare |
$12,659.55
|
| Rate for Payer: Humana Medicare Advantage |
$11,508.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,334.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,978.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,508.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,564.76
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,112.15
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,978.01
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,508.68
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,457.41
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,278.51
|
| Rate for Payer: United Healthcare Commercial |
$7,540.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,978.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,508.68
|
| Rate for Payer: Zelis Medicare |
$9,782.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,241.68
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$33,406.63
|
|
|
Service Code
|
MSDRG 205
|
| Min. Negotiated Rate |
$5,653.55 |
| Max. Negotiated Rate |
$33,406.63 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,653.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,291.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,653.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,242.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,650.96
|
| Rate for Payer: GEHA Medicare |
$19,650.96
|
| Rate for Payer: Humana ChoiceCare |
$21,616.06
|
| Rate for Payer: Humana Medicare Advantage |
$19,650.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$33,013.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,242.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,650.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$33,406.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,511.34
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,242.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,650.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,100.87
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,257.94
|
| Rate for Payer: United Healthcare Commercial |
$12,874.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,242.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,650.96
|
| Rate for Payer: Zelis Medicare |
$16,703.32
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,365.09
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC
|
Facility
|
IP
|
$16,230.50
|
|
|
Service Code
|
MSDRG 206
|
| Min. Negotiated Rate |
$4,770.15 |
| Max. Negotiated Rate |
$16,230.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,770.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,336.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,770.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,682.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,547.35
|
| Rate for Payer: GEHA Medicare |
$9,547.35
|
| Rate for Payer: Humana ChoiceCare |
$10,502.08
|
| Rate for Payer: Humana Medicare Advantage |
$9,547.35
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,039.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,682.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,547.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,230.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,366.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,682.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,547.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,652.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,356.40
|
| Rate for Payer: United Healthcare Commercial |
$6,177.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,682.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,547.35
|
| Rate for Payer: Zelis Medicare |
$8,115.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,932.99
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$32,334.26
|
|
|
Service Code
|
MSDRG 167
|
| Min. Negotiated Rate |
$8,361.85 |
| Max. Negotiated Rate |
$32,334.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,361.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,800.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,361.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,023.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,020.15
|
| Rate for Payer: GEHA Medicare |
$19,020.15
|
| Rate for Payer: Humana ChoiceCare |
$20,922.17
|
| Rate for Payer: Humana Medicare Advantage |
$19,020.15
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,953.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,023.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,020.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,334.26
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,628.21
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,023.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,020.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,198.81
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,639.75
|
| Rate for Payer: United Healthcare Commercial |
$12,461.50
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,023.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,020.15
|
| Rate for Payer: Zelis Medicare |
$16,167.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,968.16
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$68,135.20
|
|
|
Service Code
|
MSDRG 166
|
| Min. Negotiated Rate |
$12,314.75 |
| Max. Negotiated Rate |
$68,135.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,314.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$31,187.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,314.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22,001.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$40,079.53
|
| Rate for Payer: GEHA Medicare |
$40,079.53
|
| Rate for Payer: Humana ChoiceCare |
$44,087.48
|
| Rate for Payer: Humana Medicare Advantage |
$40,079.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$67,333.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22,001.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$40,079.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$68,135.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$56,111.34
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22,001.37
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$40,079.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$57,313.73
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$39,277.94
|
| Rate for Payer: United Healthcare Commercial |
$26,259.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22,001.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40,079.53
|
| Rate for Payer: Zelis Medicare |
$34,067.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$25,219.47
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$23,958.69
|
|
|
Service Code
|
MSDRG 168
|
| Min. Negotiated Rate |
$8,337.00 |
| Max. Negotiated Rate |
$23,958.69 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,337.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,966.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,337.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,979.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,093.35
|
| Rate for Payer: GEHA Medicare |
$14,093.35
|
| Rate for Payer: Humana ChoiceCare |
$15,502.68
|
| Rate for Payer: Humana Medicare Advantage |
$14,093.35
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,676.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,979.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,093.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,958.69
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,730.69
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,979.29
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,093.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,153.49
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,811.48
|
| Rate for Payer: United Healthcare Commercial |
$9,233.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,979.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,093.35
|
| Rate for Payer: Zelis Medicare |
$11,979.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,868.05
|
|
|
MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
|
Facility
|
IP
|
$31,375.12
|
|
|
Service Code
|
MSDRG 580
|
| Min. Negotiated Rate |
$5,006.75 |
| Max. Negotiated Rate |
$31,375.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,006.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,361.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,006.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,100.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,455.95
|
| Rate for Payer: GEHA Medicare |
$18,455.95
|
| Rate for Payer: Humana ChoiceCare |
$20,301.54
|
| Rate for Payer: Humana Medicare Advantage |
$18,455.95
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,006.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,100.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,455.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,375.12
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,838.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,100.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,455.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,392.01
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,086.83
|
| Rate for Payer: United Healthcare Commercial |
$12,091.86
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,100.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,455.95
|
| Rate for Payer: Zelis Medicare |
$15,687.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,613.15
|
|
|
MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC
|
Facility
|
IP
|
$57,678.57
|
|
|
Service Code
|
MSDRG 579
|
| Min. Negotiated Rate |
$9,346.40 |
| Max. Negotiated Rate |
$57,678.57 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,346.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$26,401.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,346.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,761.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$33,928.57
|
| Rate for Payer: GEHA Medicare |
$33,928.57
|
| Rate for Payer: Humana ChoiceCare |
$37,321.43
|
| Rate for Payer: Humana Medicare Advantage |
$33,928.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$57,000.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,761.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$33,928.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$57,678.57
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$47,500.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,761.22
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$33,928.57
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$48,517.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$33,250.00
|
| Rate for Payer: United Healthcare Commercial |
$22,229.11
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,761.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,928.57
|
| Rate for Payer: Zelis Medicare |
$28,839.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21,349.07
|
|
|
MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$25,468.19
|
|
|
Service Code
|
MSDRG 581
|
| Min. Negotiated Rate |
$3,777.20 |
| Max. Negotiated Rate |
$25,468.19 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,777.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,657.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,777.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,929.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,981.29
|
| Rate for Payer: GEHA Medicare |
$14,981.29
|
| Rate for Payer: Humana ChoiceCare |
$16,479.42
|
| Rate for Payer: Humana Medicare Advantage |
$14,981.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,168.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,929.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,981.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,468.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,973.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,929.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,981.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,423.24
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,681.66
|
| Rate for Payer: United Healthcare Commercial |
$9,815.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,929.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,981.29
|
| Rate for Payer: Zelis Medicare |
$12,734.10
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,426.76
|
|
