|
MS-DRG 42.00: RESPIRATORY NEOPLASMS WITHOUT CC/MCC
|
Facility
|
IP
|
$15,232.83
|
|
|
Service Code
|
MSDRG 182
|
| Min. Negotiated Rate |
$4,215.05 |
| Max. Negotiated Rate |
$15,232.83 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,215.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,783.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,215.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,702.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,960.49
|
| Rate for Payer: GEHA Medicare |
$8,960.49
|
| Rate for Payer: Humana ChoiceCare |
$9,856.54
|
| Rate for Payer: Humana Medicare Advantage |
$8,960.49
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,053.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,702.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,960.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,232.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,544.69
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,702.65
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,960.49
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,813.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,781.28
|
| Rate for Payer: United Healthcare Commercial |
$5,711.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,702.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,960.49
|
| Rate for Payer: Zelis Medicare |
$7,616.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,485.62
|
|
|
MS-DRG 42.00: RESPIRATORY SIGNS AND SYMPTOMS
|
Facility
|
IP
|
$14,845.71
|
|
|
Service Code
|
MSDRG 204
|
| Min. Negotiated Rate |
$2,883.30 |
| Max. Negotiated Rate |
$14,845.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,883.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,569.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,883.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,351.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,732.77
|
| Rate for Payer: GEHA Medicare |
$8,732.77
|
| Rate for Payer: Humana ChoiceCare |
$9,606.05
|
| Rate for Payer: Humana Medicare Advantage |
$8,732.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,671.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,351.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,732.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,845.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,225.88
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,351.65
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,732.77
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,487.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,558.11
|
| Rate for Payer: United Healthcare Commercial |
$5,531.02
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,351.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,732.77
|
| Rate for Payer: Zelis Medicare |
$7,422.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,312.05
|
|
|
MS-DRG 42.00: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS
|
Facility
|
IP
|
$47,492.71
|
|
|
Service Code
|
MSDRG 208
|
| Min. Negotiated Rate |
$15,963.15 |
| Max. Negotiated Rate |
$47,492.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15,963.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21,738.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15,963.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$28,442.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$27,936.89
|
| Rate for Payer: GEHA Medicare |
$27,936.89
|
| Rate for Payer: Humana ChoiceCare |
$30,730.58
|
| Rate for Payer: Humana Medicare Advantage |
$27,936.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$46,933.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$28,442.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$27,936.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$47,492.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$39,111.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$28,442.04
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$27,936.89
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$39,949.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27,378.15
|
| Rate for Payer: United Healthcare Commercial |
$18,303.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$28,442.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,936.89
|
| Rate for Payer: Zelis Medicare |
$23,746.36
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,578.89
|
|
|
MS-DRG 42.00: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS
|
Facility
|
IP
|
$114,444.02
|
|
|
Service Code
|
MSDRG 207
|
| Min. Negotiated Rate |
$37,355.15 |
| Max. Negotiated Rate |
$114,444.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$37,355.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$52,384.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$37,355.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$66,206.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$67,320.01
|
| Rate for Payer: GEHA Medicare |
$67,320.01
|
| Rate for Payer: Humana ChoiceCare |
$74,052.01
|
| Rate for Payer: Humana Medicare Advantage |
$67,320.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$113,097.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$66,206.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$67,320.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$114,444.02
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$94,248.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$66,206.19
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$67,320.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$96,267.61
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$65,973.61
|
| Rate for Payer: United Healthcare Commercial |
$44,106.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$66,206.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$67,320.01
|
| Rate for Payer: Zelis Medicare |
$57,222.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$42,360.16
|
|
|
MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC
|
Facility
|
IP
|
$17,980.97
|
|
|
Service Code
|
MSDRG 815
|
| Min. Negotiated Rate |
$4,002.25 |
| Max. Negotiated Rate |
$17,980.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,002.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,230.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,002.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,326.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,577.04
|
| Rate for Payer: GEHA Medicare |
$10,577.04
|
| Rate for Payer: Humana ChoiceCare |
$11,634.74
|
| Rate for Payer: Humana Medicare Advantage |
$10,577.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,769.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,326.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,577.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,980.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,807.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,326.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,577.04
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,125.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,365.50
|
| Rate for Payer: United Healthcare Commercial |
$6,929.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,326.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,577.04
|
| Rate for Payer: Zelis Medicare |
$8,990.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,655.45
|
|
|
MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC
|
Facility
|
IP
|
$36,993.63
|
|
|
Service Code
|
MSDRG 814
|
| Min. Negotiated Rate |
$7,340.20 |
| Max. Negotiated Rate |
$36,993.63 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,340.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,933.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,340.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,219.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,760.96
|
| Rate for Payer: GEHA Medicare |
$21,760.96
|
| Rate for Payer: Humana ChoiceCare |
$23,937.06
|
| Rate for Payer: Humana Medicare Advantage |
$21,760.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$36,558.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,219.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,760.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$36,993.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30,465.34
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,219.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,760.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31,118.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21,325.74
|
| Rate for Payer: United Healthcare Commercial |
$14,257.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,219.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,760.96
|
| Rate for Payer: Zelis Medicare |
$18,496.82
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,692.77
|
|
|
MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,631.19
|
|
|
Service Code
|
MSDRG 816
|
| Min. Negotiated Rate |
$2,581.25 |
| Max. Negotiated Rate |
$12,631.19 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,581.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,341.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,581.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,818.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,430.11
|
| Rate for Payer: GEHA Medicare |
$7,430.11
|
| Rate for Payer: Humana ChoiceCare |
$8,173.12
|
| Rate for Payer: Humana Medicare Advantage |
$7,430.11
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,482.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,818.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,430.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,631.19
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,402.15
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,818.43
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,430.11
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,625.06
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,281.51
|
| Rate for Payer: United Healthcare Commercial |
$4,497.11
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,818.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,430.11
|
| Rate for Payer: Zelis Medicare |
$6,315.59
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,319.07
|
|
|
MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH CC
|
Facility
|
IP
|
$60,612.58
|
|
|
Service Code
|
MSDRG 467
|
| Min. Negotiated Rate |
$21,712.95 |
| Max. Negotiated Rate |
$60,612.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$21,712.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$27,744.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$21,712.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$38,592.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35,654.46
|
| Rate for Payer: GEHA Medicare |
$35,654.46
|
| Rate for Payer: Humana ChoiceCare |
$39,219.91
|
| Rate for Payer: Humana Medicare Advantage |
$35,654.46
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$59,899.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$38,592.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35,654.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$60,612.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$49,916.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$38,592.39
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35,654.46
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$50,985.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34,941.37
|
| Rate for Payer: United Healthcare Commercial |
$23,359.86
|
| Rate for Payer: United Healthcare Managed Medicaid |
$38,592.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35,654.46
|
| Rate for Payer: Zelis Medicare |
$30,306.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,435.06
|
|
|
MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$90,154.40
|
|
|
Service Code
|
MSDRG 466
|
| Min. Negotiated Rate |
$31,744.65 |
| Max. Negotiated Rate |
$90,154.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$31,744.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$41,266.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$31,744.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$56,301.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$53,032.00
|
| Rate for Payer: GEHA Medicare |
$53,032.00
|
| Rate for Payer: Humana ChoiceCare |
$58,335.20
|
| Rate for Payer: Humana Medicare Advantage |
$53,032.00
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$89,093.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$56,301.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$53,032.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$90,154.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$74,244.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$56,301.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$53,032.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$75,835.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$51,971.36
|
| Rate for Payer: United Healthcare Commercial |
$34,745.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$56,301.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53,032.00
|
| Rate for Payer: Zelis Medicare |
$45,077.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33,369.63
|
|
|
MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$46,422.09
|
|
|
Service Code
|
MSDRG 468
|
| Min. Negotiated Rate |
$16,958.55 |
| Max. Negotiated Rate |
$46,422.09 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,958.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21,248.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,958.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$30,199.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$27,307.11
|
| Rate for Payer: GEHA Medicare |
$27,307.11
|
| Rate for Payer: Humana ChoiceCare |
$30,037.82
|
| Rate for Payer: Humana Medicare Advantage |
$27,307.11
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$45,875.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$30,199.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$27,307.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46,422.09
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$38,229.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$30,199.26
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$27,307.11
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$39,049.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$26,760.97
|
| Rate for Payer: United Healthcare Commercial |
$17,890.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$30,199.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,307.11
|
| Rate for Payer: Zelis Medicare |
$23,211.04
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,182.62
|
|
|
MS-DRG 42.00: SALIVARY GLAND PROCEDURES
|
Facility
|
IP
|
$24,296.71
|
|
|
Service Code
|
MSDRG 139
|
| Min. Negotiated Rate |
$3,719.80 |
| Max. Negotiated Rate |
$24,296.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,719.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,121.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,719.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,828.36
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,292.18
|
| Rate for Payer: GEHA Medicare |
$14,292.18
|
| Rate for Payer: Humana ChoiceCare |
$15,721.40
|
| Rate for Payer: Humana Medicare Advantage |
$14,292.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,010.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,828.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,292.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,296.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,009.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,828.36
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,292.18
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,437.82
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,006.34
|
| Rate for Payer: United Healthcare Commercial |
$9,363.86
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,828.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,292.18
|
| Rate for Payer: Zelis Medicare |
$12,148.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,993.15
|
|
|
MS-DRG 42.00: SEIZURES WITH MCC
|
Facility
|
IP
|
$35,132.00
|
|
|
Service Code
|
MSDRG 100
|
| Min. Negotiated Rate |
$3,330.95 |
| Max. Negotiated Rate |
$35,132.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,330.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,080.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,330.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,141.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,665.88
|
| Rate for Payer: GEHA Medicare |
$20,665.88
|
| Rate for Payer: Humana ChoiceCare |
$22,732.47
|
| Rate for Payer: Humana Medicare Advantage |
$20,665.88
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,718.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,141.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,665.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,132.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,932.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,141.91
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,665.88
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,552.21
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,252.56
|
| Rate for Payer: United Healthcare Commercial |
$13,539.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,141.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,665.88
|
| Rate for Payer: Zelis Medicare |
$17,566.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,003.72
|
|
|
MS-DRG 42.00: SEIZURES WITHOUT MCC
|
Facility
|
IP
|
$16,462.77
|
|
|
Service Code
|
MSDRG 101
|
| Min. Negotiated Rate |
$2,814.35 |
| Max. Negotiated Rate |
$16,462.77 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,814.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,465.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,814.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,229.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,683.98
|
| Rate for Payer: GEHA Medicare |
$9,683.98
|
| Rate for Payer: Humana ChoiceCare |
$10,652.38
|
| Rate for Payer: Humana Medicare Advantage |
$9,683.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,269.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,229.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,683.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,462.77
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,557.57
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,229.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,683.98
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,848.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,490.30
|
| Rate for Payer: United Healthcare Commercial |
$6,285.99
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,229.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,683.98
|
| Rate for Payer: Zelis Medicare |
$8,231.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,037.14
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITH CC
|
Facility
|
IP
|
$21,325.53
|
|
|
Service Code
|
MSDRG 549
|
| Min. Negotiated Rate |
$6,416.55 |
| Max. Negotiated Rate |
$21,325.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,416.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,761.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,416.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,589.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,544.43
|
| Rate for Payer: GEHA Medicare |
$12,544.43
|
| Rate for Payer: Humana ChoiceCare |
$13,798.87
|
| Rate for Payer: Humana Medicare Advantage |
$12,544.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,074.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,589.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,544.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,325.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,562.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,589.04
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,544.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,938.53
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,293.54
|
| Rate for Payer: United Healthcare Commercial |
$8,218.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,589.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,544.43
|
| Rate for Payer: Zelis Medicare |
$10,662.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,893.40
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITH MCC
|
Facility
|
IP
|
$35,650.51
|
|
|
Service Code
|
MSDRG 548
|
| Min. Negotiated Rate |
$11,277.70 |
| Max. Negotiated Rate |
$35,650.51 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,277.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,318.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,277.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,170.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,970.89
|
| Rate for Payer: GEHA Medicare |
$20,970.89
|
| Rate for Payer: Humana ChoiceCare |
$23,067.98
|
| Rate for Payer: Humana Medicare Advantage |
$20,970.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$35,231.10
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,170.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,970.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,650.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,359.25
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,170.62
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,970.89
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,988.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,551.47
|
| Rate for Payer: United Healthcare Commercial |
$13,739.57
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,170.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,970.89
|
| Rate for Payer: Zelis Medicare |
$17,825.26
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,195.63
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$15,592.16
|
|
|
Service Code
|
MSDRG 550
|
| Min. Negotiated Rate |
$3,860.50 |
| Max. Negotiated Rate |
$15,592.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,860.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,983.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,860.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,076.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,171.86
|
| Rate for Payer: GEHA Medicare |
$9,171.86
|
| Rate for Payer: Humana ChoiceCare |
$10,089.05
|
| Rate for Payer: Humana Medicare Advantage |
$9,171.86
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,408.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,076.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,171.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,592.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,840.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,076.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,171.86
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,115.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,988.42
|
| Rate for Payer: United Healthcare Commercial |
$5,879.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,076.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,171.86
|
| Rate for Payer: Zelis Medicare |
$7,796.08
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,646.76
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS
|
Facility
|
IP
|
$123,102.70
|
|
|
Service Code
|
MSDRG 870
|
| Min. Negotiated Rate |
$29,222.55 |
| Max. Negotiated Rate |
$123,102.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$29,222.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$56,347.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$29,222.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$51,849.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$72,413.35
|
| Rate for Payer: GEHA Medicare |
$72,413.35
|
| Rate for Payer: Humana ChoiceCare |
$79,654.68
|
| Rate for Payer: Humana Medicare Advantage |
$72,413.35
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$121,654.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51,849.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$72,413.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$123,102.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$101,378.69
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51,849.39
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$72,413.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$103,551.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$70,965.08
|
| Rate for Payer: United Healthcare Commercial |
$47,443.33
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51,849.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$72,413.35
|
| Rate for Payer: Zelis Medicare |
$61,551.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$45,565.07
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC
|
Facility
|
IP
|
$34,721.45
|
|
|
Service Code
|
MSDRG 871
|
| Min. Negotiated Rate |
$8,590.40 |
| Max. Negotiated Rate |
$34,721.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,590.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,893.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,590.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,426.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,424.38
|
| Rate for Payer: GEHA Medicare |
$20,424.38
|
| Rate for Payer: Humana ChoiceCare |
$22,466.82
|
| Rate for Payer: Humana Medicare Advantage |
$20,424.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,312.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,426.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,424.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,721.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,594.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,426.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,424.38
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,206.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,015.89
|
| Rate for Payer: United Healthcare Commercial |
$13,381.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,426.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,424.38
|
| Rate for Payer: Zelis Medicare |
$17,360.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,851.75
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC
|
Facility
|
IP
|
$18,244.65
|
|
|
Service Code
|
MSDRG 872
|
| Min. Negotiated Rate |
$5,198.20 |
| Max. Negotiated Rate |
$18,244.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,198.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,351.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,198.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,438.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,732.15
|
| Rate for Payer: GEHA Medicare |
$10,732.15
|
| Rate for Payer: Humana ChoiceCare |
$11,805.36
|
| Rate for Payer: Humana Medicare Advantage |
$10,732.15
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,030.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,438.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,732.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,244.65
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,025.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,438.24
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,732.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,346.97
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,517.51
|
| Rate for Payer: United Healthcare Commercial |
$7,031.42
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,438.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,732.15
|
| Rate for Payer: Zelis Medicare |
$9,122.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,753.05
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
|
Facility
|
IP
|
$34,705.53
|
|
|
Service Code
|
MSDRG 511
|
| Min. Negotiated Rate |
$4,703.30 |
| Max. Negotiated Rate |
$34,705.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,703.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,885.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,703.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,564.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,415.02
|
| Rate for Payer: GEHA Medicare |
$20,415.02
|
| Rate for Payer: Humana ChoiceCare |
$22,456.52
|
| Rate for Payer: Humana Medicare Advantage |
$20,415.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,297.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,564.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,415.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$34,705.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28,581.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,564.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,415.02
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,193.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,006.72
|
| Rate for Payer: United Healthcare Commercial |
$13,375.38
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,564.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,415.02
|
| Rate for Payer: Zelis Medicare |
$17,352.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,845.86
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC
|
Facility
|
IP
|
$50,577.12
|
|
|
Service Code
|
MSDRG 510
|
| Min. Negotiated Rate |
$7,095.55 |
| Max. Negotiated Rate |
$50,577.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,095.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,150.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,095.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,787.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29,751.25
|
| Rate for Payer: GEHA Medicare |
$29,751.25
|
| Rate for Payer: Humana ChoiceCare |
$32,726.38
|
| Rate for Payer: Humana Medicare Advantage |
$29,751.25
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49,982.10
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,787.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29,751.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$50,577.12
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$41,651.75
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,787.71
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29,751.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$42,544.29
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,156.22
|
| Rate for Payer: United Healthcare Commercial |
$19,492.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,787.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,751.25
|
| Rate for Payer: Zelis Medicare |
$25,288.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18,720.56
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$28,451.74
|
|
|
Service Code
|
MSDRG 512
|
| Min. Negotiated Rate |
$4,311.65 |
| Max. Negotiated Rate |
$28,451.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,311.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,023.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,311.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,873.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,736.32
|
| Rate for Payer: GEHA Medicare |
$16,736.32
|
| Rate for Payer: Humana ChoiceCare |
$18,409.95
|
| Rate for Payer: Humana Medicare Advantage |
$16,736.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,117.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,873.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,736.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,451.74
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,430.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,873.18
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,736.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,932.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,401.59
|
| Rate for Payer: United Healthcare Commercial |
$10,965.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,873.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,736.32
|
| Rate for Payer: Zelis Medicare |
$14,225.87
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,531.09
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$23,829.53
|
|
|
Service Code
|
MSDRG 555
|
| Min. Negotiated Rate |
$3,580.15 |
| Max. Negotiated Rate |
$23,829.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,580.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,907.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,580.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,581.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,017.37
|
| Rate for Payer: GEHA Medicare |
$14,017.37
|
| Rate for Payer: Humana ChoiceCare |
$15,419.11
|
| Rate for Payer: Humana Medicare Advantage |
$14,017.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23,549.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,581.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,017.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,829.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,624.32
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,581.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,017.37
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,044.84
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,737.02
|
| Rate for Payer: United Healthcare Commercial |
$9,183.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,581.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,017.37
|
| Rate for Payer: Zelis Medicare |
$11,914.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,820.23
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC
|
Facility
|
IP
|
$14,926.05
|
|
|
Service Code
|
MSDRG 556
|
| Min. Negotiated Rate |
$2,014.25 |
| Max. Negotiated Rate |
$14,926.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,014.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,613.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,014.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,817.49
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,780.03
|
| Rate for Payer: GEHA Medicare |
$8,780.03
|
| Rate for Payer: Humana ChoiceCare |
$9,658.03
|
| Rate for Payer: Humana Medicare Advantage |
$8,780.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,750.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,817.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,780.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,926.05
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,292.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,817.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,780.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,555.44
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,604.43
|
| Rate for Payer: United Healthcare Commercial |
$5,568.53
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,817.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,780.03
|
| Rate for Payer: Zelis Medicare |
$7,463.03
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,348.07
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$22,760.69
|
|
|
Service Code
|
MSDRG 947
|
| Min. Negotiated Rate |
$4,849.60 |
| Max. Negotiated Rate |
$22,760.69 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,849.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,418.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,849.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,822.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,388.64
|
| Rate for Payer: GEHA Medicare |
$13,388.64
|
| Rate for Payer: Humana ChoiceCare |
$14,727.50
|
| Rate for Payer: Humana Medicare Advantage |
$13,388.64
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,492.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,822.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,388.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,760.69
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,744.10
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,822.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,388.64
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,145.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,120.87
|
| Rate for Payer: United Healthcare Commercial |
$8,771.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,822.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,388.64
|
| Rate for Payer: Zelis Medicare |
$11,380.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,424.61
|
|
