|
MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$45,178.04
|
|
|
Service Code
|
MSDRG 253
|
| Min. Negotiated Rate |
$10,670.10 |
| Max. Negotiated Rate |
$45,178.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,670.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$20,679.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,670.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,098.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$26,575.32
|
| Rate for Payer: GEHA Medicare |
$26,575.32
|
| Rate for Payer: Humana ChoiceCare |
$29,232.85
|
| Rate for Payer: Humana Medicare Advantage |
$26,575.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$44,646.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,098.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$26,575.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$45,178.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$37,205.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,098.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$26,575.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$38,002.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$26,043.81
|
| Rate for Payer: United Healthcare Commercial |
$17,411.46
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,098.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,575.32
|
| Rate for Payer: Zelis Medicare |
$22,589.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16,722.15
|
|
|
MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$60,704.60
|
|
|
Service Code
|
MSDRG 252
|
| Min. Negotiated Rate |
$13,387.50 |
| Max. Negotiated Rate |
$60,704.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$13,387.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$27,786.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$13,387.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23,895.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35,708.59
|
| Rate for Payer: GEHA Medicare |
$35,708.59
|
| Rate for Payer: Humana ChoiceCare |
$39,279.45
|
| Rate for Payer: Humana Medicare Advantage |
$35,708.59
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$59,990.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23,895.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35,708.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$60,704.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$49,992.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23,895.14
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35,708.59
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$51,063.28
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34,994.42
|
| Rate for Payer: United Healthcare Commercial |
$23,395.33
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23,895.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35,708.59
|
| Rate for Payer: Zelis Medicare |
$30,352.30
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,469.12
|
|
|
MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$30,957.51
|
|
|
Service Code
|
MSDRG 254
|
| Min. Negotiated Rate |
$7,540.05 |
| Max. Negotiated Rate |
$30,957.51 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,540.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,170.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,540.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,572.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,210.30
|
| Rate for Payer: GEHA Medicare |
$18,210.30
|
| Rate for Payer: Humana ChoiceCare |
$20,031.33
|
| Rate for Payer: Humana Medicare Advantage |
$18,210.30
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,593.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,572.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,210.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30,957.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,494.42
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,572.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,210.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,040.73
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,846.09
|
| Rate for Payer: United Healthcare Commercial |
$11,930.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,572.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,210.30
|
| Rate for Payer: Zelis Medicare |
$15,478.75
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,458.57
|
|
|
MS-DRG 42.00: OTITIS MEDIA AND URI WITH MCC
|
Facility
|
IP
|
$20,081.49
|
|
|
Service Code
|
MSDRG 152
|
| Min. Negotiated Rate |
$2,329.25 |
| Max. Negotiated Rate |
$20,081.49 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,329.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,191.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,329.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,812.64
|
| Rate for Payer: GEHA Medicare |
$11,812.64
|
| Rate for Payer: Humana ChoiceCare |
$12,993.90
|
| Rate for Payer: Humana Medicare Advantage |
$11,812.64
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,845.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,373.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,812.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,081.49
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16,537.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,373.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,812.64
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,892.08
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,576.39
|
| Rate for Payer: United Healthcare Commercial |
$7,739.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,373.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,812.64
|
| Rate for Payer: Zelis Medicare |
$10,040.74
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,432.94
|
|
|
MS-DRG 42.00: OTITIS MEDIA AND URI WITHOUT MCC
|
Facility
|
IP
|
$13,395.17
|
|
|
Service Code
|
MSDRG 153
|
| Min. Negotiated Rate |
$2,172.10 |
| Max. Negotiated Rate |
$13,395.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,172.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,764.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,172.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,096.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,879.51
|
| Rate for Payer: GEHA Medicare |
$7,879.51
|
| Rate for Payer: Humana ChoiceCare |
$8,667.46
|
| Rate for Payer: Humana Medicare Advantage |
$7,879.51
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,237.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,096.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,879.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,395.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,031.31
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,096.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,879.51
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,267.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,721.92
|
| Rate for Payer: United Healthcare Commercial |
$4,853.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,096.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,879.51
|
| Rate for Payer: Zelis Medicare |
$6,697.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,661.64
|
|
|
MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$49,697.63
|
|
|
Service Code
|
MSDRG 406
|
| Min. Negotiated Rate |
$11,846.80 |
| Max. Negotiated Rate |
$49,697.63 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,846.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$22,748.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,846.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21,175.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29,233.90
|
| Rate for Payer: GEHA Medicare |
$29,233.90
|
| Rate for Payer: Humana ChoiceCare |
$32,157.29
|
| Rate for Payer: Humana Medicare Advantage |
$29,233.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49,112.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21,175.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29,233.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49,697.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$40,927.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21,175.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29,233.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$41,804.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28,649.22
|
| Rate for Payer: United Healthcare Commercial |
$19,153.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21,175.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,233.90
|
| Rate for Payer: Zelis Medicare |
$24,848.81
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18,395.02
|
|
|
MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$96,066.66
|
|
|
Service Code
|
MSDRG 405
|
| Min. Negotiated Rate |
$16,165.45 |
| Max. Negotiated Rate |
$96,066.66 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,165.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$43,972.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,165.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$28,799.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56,509.80
|
| Rate for Payer: GEHA Medicare |
$56,509.80
|
| Rate for Payer: Humana ChoiceCare |
$62,160.78
|
| Rate for Payer: Humana Medicare Advantage |
$56,509.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$94,936.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$28,799.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56,509.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$96,066.66
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$79,113.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$28,799.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56,509.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$80,809.01
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55,379.60
|
| Rate for Payer: United Healthcare Commercial |
$37,023.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$28,799.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56,509.80
|
| Rate for Payer: Zelis Medicare |
$48,033.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35,557.99
|
|
|
MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$37,795.28
|
|
|
Service Code
|
MSDRG 407
|
| Min. Negotiated Rate |
$10,658.90 |
| Max. Negotiated Rate |
$37,795.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,658.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,299.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,658.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,078.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22,232.52
|
| Rate for Payer: GEHA Medicare |
$22,232.52
|
| Rate for Payer: Humana ChoiceCare |
$24,455.77
|
| Rate for Payer: Humana Medicare Advantage |
$22,232.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37,350.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,078.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22,232.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,795.28
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31,125.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,078.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22,232.52
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,792.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,787.87
|
| Rate for Payer: United Healthcare Commercial |
$14,566.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,078.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,232.52
|
| Rate for Payer: Zelis Medicare |
$18,897.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,989.49
|
|
|
MS-DRG 42.00: PANCREAS TRANSPLANT
|
Facility
|
IP
|
$141,090.75
|
|
|
Service Code
|
MSDRG 010
|
| Min. Negotiated Rate |
$22,584.10 |
| Max. Negotiated Rate |
$141,090.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$22,584.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$64,581.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$22,584.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$40,130.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$82,994.56
|
| Rate for Payer: GEHA Medicare |
$82,994.56
|
| Rate for Payer: Humana ChoiceCare |
$91,294.02
|
| Rate for Payer: Humana Medicare Advantage |
$82,994.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$139,430.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$40,130.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$82,994.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$141,090.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$116,192.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$40,130.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$82,994.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$118,682.22
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$81,334.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$40,130.27
|
| Rate for Payer: Zelis Medicare |
$70,545.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$52,223.15
|
|
|
MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
|
Facility
|
IP
|
$18,773.76
|
|
|
Service Code
|
MSDRG 543
|
| Min. Negotiated Rate |
$6,688.15 |
| Max. Negotiated Rate |
$18,773.76 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,688.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,593.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,688.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,068.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,043.39
|
| Rate for Payer: GEHA Medicare |
$11,043.39
|
| Rate for Payer: Humana ChoiceCare |
$12,147.73
|
| Rate for Payer: Humana Medicare Advantage |
$11,043.39
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,552.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,068.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,043.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,773.76
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,460.75
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,068.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,043.39
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,792.05
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,822.52
|
| Rate for Payer: United Healthcare Commercial |
$7,235.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,068.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,043.39
|
| Rate for Payer: Zelis Medicare |
$9,386.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,948.90
|
|
|
MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
|
Facility
|
IP
|
$33,004.96
|
|
|
Service Code
|
MSDRG 542
|
| Min. Negotiated Rate |
$9,724.40 |
| Max. Negotiated Rate |
$33,004.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,724.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,107.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,724.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,428.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,414.68
|
| Rate for Payer: GEHA Medicare |
$19,414.68
|
| Rate for Payer: Humana ChoiceCare |
$21,356.15
|
| Rate for Payer: Humana Medicare Advantage |
$19,414.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,616.66
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,428.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,414.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$33,004.96
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,180.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,428.52
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,414.68
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,762.99
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,026.39
|
| Rate for Payer: United Healthcare Commercial |
$12,719.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,428.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,414.68
|
| Rate for Payer: Zelis Medicare |
$16,502.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,216.41
|
|
|
MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$14,037.92
|
|
|
Service Code
|
MSDRG 544
|
| Min. Negotiated Rate |
$4,949.84 |
| Max. Negotiated Rate |
$14,037.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,370.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,121.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,370.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,742.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,257.60
|
| Rate for Payer: GEHA Medicare |
$8,257.60
|
| Rate for Payer: Humana ChoiceCare |
$9,083.36
|
| Rate for Payer: Humana Medicare Advantage |
$8,257.60
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,872.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,742.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,257.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,037.92
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,560.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,742.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,257.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,808.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,092.45
|
| Rate for Payer: United Healthcare Commercial |
$5,153.87
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,742.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,257.60
|
| Rate for Payer: Zelis Medicare |
$7,018.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,949.84
|
|
|
MS-DRG 42.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC
|
Facility
|
IP
|
$37,211.30
|
|
|
Service Code
|
MSDRG 734
|
| Min. Negotiated Rate |
$11,362.75 |
| Max. Negotiated Rate |
$37,211.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,362.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17,032.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,362.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,320.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,889.00
|
| Rate for Payer: GEHA Medicare |
$21,889.00
|
| Rate for Payer: Humana ChoiceCare |
$24,077.90
|
| Rate for Payer: Humana Medicare Advantage |
$21,889.00
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,773.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,320.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,889.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37,211.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,644.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,320.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,889.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,301.27
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,451.22
|
| Rate for Payer: United Healthcare Commercial |
$14,341.10
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,320.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,889.00
|
| Rate for Payer: Zelis Medicare |
$18,605.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,773.34
|
|
|
MS-DRG 42.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$21,481.27
|
|
|
Service Code
|
MSDRG 735
|
| Min. Negotiated Rate |
$7,951.05 |
| Max. Negotiated Rate |
$21,481.27 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,415.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,832.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,415.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,117.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,636.04
|
| Rate for Payer: GEHA Medicare |
$12,636.04
|
| Rate for Payer: Humana ChoiceCare |
$13,899.64
|
| Rate for Payer: Humana Medicare Advantage |
$12,636.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,228.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,117.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,636.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,481.27
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,690.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,117.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,636.04
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,069.54
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,383.32
|
| Rate for Payer: United Healthcare Commercial |
$8,278.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,117.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,636.04
|
| Rate for Payer: Zelis Medicare |
$10,740.63
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,951.05
|
|
|
MS-DRG 42.00: PENIS PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$39,764.85
|
|
|
Service Code
|
MSDRG 709
|
| Min. Negotiated Rate |
$5,815.60 |
| Max. Negotiated Rate |
$39,764.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,815.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,201.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,815.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,528.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,391.09
|
| Rate for Payer: GEHA Medicare |
$23,391.09
|
| Rate for Payer: Humana ChoiceCare |
$25,730.20
|
| Rate for Payer: Humana Medicare Advantage |
$23,391.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,297.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,528.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,391.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39,764.85
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,747.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,528.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,391.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,449.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,923.27
|
| Rate for Payer: United Healthcare Commercial |
$15,325.22
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,528.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,391.09
|
| Rate for Payer: Zelis Medicare |
$19,882.43
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,718.50
|
|
|
MS-DRG 42.00: PENIS PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$26,568.86
|
|
|
Service Code
|
MSDRG 710
|
| Min. Negotiated Rate |
$4,218.55 |
| Max. Negotiated Rate |
$26,568.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,218.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,161.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,218.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,708.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,628.74
|
| Rate for Payer: GEHA Medicare |
$15,628.74
|
| Rate for Payer: Humana ChoiceCare |
$17,191.61
|
| Rate for Payer: Humana Medicare Advantage |
$15,628.74
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,256.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,708.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,628.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,568.86
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,880.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,708.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,628.74
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,349.10
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,316.17
|
| Rate for Payer: United Healthcare Commercial |
$10,239.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,708.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,628.74
|
| Rate for Payer: Zelis Medicare |
$13,284.43
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,834.17
|
|
|
MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC
|
Facility
|
IP
|
$74,636.40
|
|
|
Service Code
|
MSDRG 273
|
| Min. Negotiated Rate |
$25,612.47 |
| Max. Negotiated Rate |
$74,636.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$42,130.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$31,673.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$42,130.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$74,636.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$40,704.08
|
| Rate for Payer: GEHA Medicare |
$40,704.08
|
| Rate for Payer: Humana ChoiceCare |
$44,774.49
|
| Rate for Payer: Humana Medicare Advantage |
$40,704.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$68,382.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$74,636.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$40,704.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$69,196.94
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$56,985.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$74,636.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$40,704.08
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58,206.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$39,890.00
|
| Rate for Payer: United Healthcare Commercial |
$26,668.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$74,636.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40,704.08
|
| Rate for Payer: Zelis Medicare |
$34,598.47
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$25,612.47
|
|
|
MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$55,229.43
|
|
|
Service Code
|
MSDRG 274
|
| Min. Negotiated Rate |
$20,442.55 |
| Max. Negotiated Rate |
$55,229.43 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$30,203.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,280.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$30,203.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$53,581.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$32,487.90
|
| Rate for Payer: GEHA Medicare |
$32,487.90
|
| Rate for Payer: Humana ChoiceCare |
$35,736.69
|
| Rate for Payer: Humana Medicare Advantage |
$32,487.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$54,579.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$53,581.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$32,487.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$55,229.43
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$45,483.06
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$53,581.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$32,487.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$46,457.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$31,838.14
|
| Rate for Payer: United Healthcare Commercial |
$21,285.22
|
| Rate for Payer: United Healthcare Managed Medicaid |
$53,581.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,487.90
|
| Rate for Payer: Zelis Medicare |
$27,614.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,442.55
|
|
|
MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES
|
Facility
|
IP
|
$69,227.57
|
|
|
Service Code
|
MSDRG 321
|
| Min. Negotiated Rate |
$18,646.54 |
| Max. Negotiated Rate |
$69,227.57 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$39,066.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,059.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$39,066.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$69,227.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29,633.63
|
| Rate for Payer: GEHA Medicare |
$29,633.63
|
| Rate for Payer: Humana ChoiceCare |
$32,596.99
|
| Rate for Payer: Humana Medicare Advantage |
$29,633.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49,784.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$69,227.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29,633.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$50,377.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$41,487.08
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$69,227.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29,633.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$42,376.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,040.96
|
| Rate for Payer: United Healthcare Commercial |
$19,415.18
|
| Rate for Payer: United Healthcare Managed Medicaid |
$69,227.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,633.63
|
| Rate for Payer: Zelis Medicare |
$25,188.59
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18,646.54
|
|
|
MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$48,737.80
|
|
|
Service Code
|
MSDRG 322
|
| Min. Negotiated Rate |
$11,850.26 |
| Max. Negotiated Rate |
$48,737.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27,459.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,654.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27,459.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48,737.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,832.77
|
| Rate for Payer: GEHA Medicare |
$18,832.77
|
| Rate for Payer: Humana ChoiceCare |
$20,716.05
|
| Rate for Payer: Humana Medicare Advantage |
$18,832.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,639.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$48,737.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,832.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,015.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,365.88
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$48,737.80
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,832.77
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,930.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,456.11
|
| Rate for Payer: United Healthcare Commercial |
$12,338.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$48,737.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,832.77
|
| Rate for Payer: Zelis Medicare |
$16,007.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,850.26
|
|
|
MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$40,923.95
|
|
|
Service Code
|
MSDRG 250
|
| Min. Negotiated Rate |
$12,037.55 |
| Max. Negotiated Rate |
$40,923.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12,037.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,732.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12,037.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21,512.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,072.91
|
| Rate for Payer: GEHA Medicare |
$24,072.91
|
| Rate for Payer: Humana ChoiceCare |
$26,480.20
|
| Rate for Payer: Humana Medicare Advantage |
$24,072.91
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$40,442.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21,512.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,072.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40,923.95
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$33,702.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21,512.02
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,072.91
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$34,424.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,591.45
|
| Rate for Payer: United Healthcare Commercial |
$15,771.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21,512.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,072.91
|
| Rate for Payer: Zelis Medicare |
$20,461.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,147.53
|
|
|
MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$27,651.88
|
|
|
Service Code
|
MSDRG 251
|
| Min. Negotiated Rate |
$8,197.70 |
| Max. Negotiated Rate |
$27,651.88 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,197.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,657.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,197.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,733.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,265.81
|
| Rate for Payer: GEHA Medicare |
$16,265.81
|
| Rate for Payer: Humana ChoiceCare |
$17,892.39
|
| Rate for Payer: Humana Medicare Advantage |
$16,265.81
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,326.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,733.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,265.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,651.88
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,772.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,733.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,265.81
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,260.11
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,940.49
|
| Rate for Payer: United Healthcare Commercial |
$10,656.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,733.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,265.81
|
| Rate for Payer: Zelis Medicare |
$13,825.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,235.03
|
|
|
MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR
|
Facility
|
IP
|
$39,961.29
|
|
|
Service Code
|
MSDRG 041
|
| Min. Negotiated Rate |
$9,910.60 |
| Max. Negotiated Rate |
$39,961.29 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,910.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,291.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,910.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17,757.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,506.64
|
| Rate for Payer: GEHA Medicare |
$23,506.64
|
| Rate for Payer: Humana ChoiceCare |
$25,857.30
|
| Rate for Payer: Humana Medicare Advantage |
$23,506.64
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,491.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17,757.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,506.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39,961.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,909.30
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17,757.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,506.64
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,614.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,036.51
|
| Rate for Payer: United Healthcare Commercial |
$15,400.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17,757.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,506.64
|
| Rate for Payer: Zelis Medicare |
$19,980.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,791.21
|
|
|
MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC
|
Facility
|
IP
|
$66,751.37
|
|
|
Service Code
|
MSDRG 040
|
| Min. Negotiated Rate |
$22,683.15 |
| Max. Negotiated Rate |
$66,751.37 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$22,683.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$30,554.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$22,683.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$40,305.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$39,265.51
|
| Rate for Payer: GEHA Medicare |
$39,265.51
|
| Rate for Payer: Humana ChoiceCare |
$43,192.06
|
| Rate for Payer: Humana Medicare Advantage |
$39,265.51
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$65,966.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$40,305.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$39,265.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$66,751.37
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$54,971.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$40,305.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$39,265.51
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$56,149.68
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$38,480.20
|
| Rate for Payer: United Healthcare Commercial |
$25,725.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$40,305.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39,265.51
|
| Rate for Payer: Zelis Medicare |
$33,375.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$24,707.26
|
|
|
MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$31,102.64
|
|
|
Service Code
|
MSDRG 042
|
| Min. Negotiated Rate |
$8,070.30 |
| Max. Negotiated Rate |
$31,102.64 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,070.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,236.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,070.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,508.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,295.67
|
| Rate for Payer: GEHA Medicare |
$18,295.67
|
| Rate for Payer: Humana ChoiceCare |
$20,125.24
|
| Rate for Payer: Humana Medicare Advantage |
$18,295.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,736.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,508.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,295.67
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,102.64
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,613.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,508.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,295.67
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,162.81
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,929.76
|
| Rate for Payer: United Healthcare Commercial |
$11,986.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,508.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,295.67
|
| Rate for Payer: Zelis Medicare |
$15,551.32
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,512.28
|
|
