|
MS-DRG 42.00: SKIN ULCERS WITH CC
|
Facility
|
IP
|
$21,636.97
|
|
|
Service Code
|
MSDRG 593
|
| Min. Negotiated Rate |
$3,644.90 |
| Max. Negotiated Rate |
$21,636.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,644.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,903.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,644.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,696.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,727.63
|
| Rate for Payer: GEHA Medicare |
$12,727.63
|
| Rate for Payer: Humana ChoiceCare |
$14,000.39
|
| Rate for Payer: Humana Medicare Advantage |
$12,727.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$21,382.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,696.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,727.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,636.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,818.68
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,696.14
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,727.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,200.51
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,473.08
|
| Rate for Payer: United Healthcare Commercial |
$8,338.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,696.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,727.63
|
| Rate for Payer: Zelis Medicare |
$10,818.49
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,008.69
|
|
|
MS-DRG 42.00: SKIN ULCERS WITH MCC
|
Facility
|
IP
|
$36,388.43
|
|
|
Service Code
|
MSDRG 592
|
| Min. Negotiated Rate |
$7,205.10 |
| Max. Negotiated Rate |
$36,388.43 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,205.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,656.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,205.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12,981.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$21,404.96
|
| Rate for Payer: GEHA Medicare |
$21,404.96
|
| Rate for Payer: Humana ChoiceCare |
$23,545.46
|
| Rate for Payer: Humana Medicare Advantage |
$21,404.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$35,960.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12,981.10
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$21,404.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$36,388.43
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,966.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12,981.10
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$21,404.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$30,609.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,976.86
|
| Rate for Payer: United Healthcare Commercial |
$14,023.97
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12,981.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,404.96
|
| Rate for Payer: Zelis Medicare |
$18,194.22
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,468.76
|
|
|
MS-DRG 42.00: SKIN ULCERS WITHOUT CC/MCC
|
Facility
|
IP
|
$15,396.42
|
|
|
Service Code
|
MSDRG 594
|
| Min. Negotiated Rate |
$2,239.65 |
| Max. Negotiated Rate |
$15,396.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,239.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,874.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,239.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,215.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,056.72
|
| Rate for Payer: GEHA Medicare |
$9,056.72
|
| Rate for Payer: Humana ChoiceCare |
$9,962.39
|
| Rate for Payer: Humana Medicare Advantage |
$9,056.72
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,215.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,215.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,056.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,396.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,679.41
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,215.39
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,056.72
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,951.11
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,875.59
|
| Rate for Payer: United Healthcare Commercial |
$5,788.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,215.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,056.72
|
| Rate for Payer: Zelis Medicare |
$7,698.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,558.98
|
|
|
MS-DRG 42.00: SOFT TISSUE PROCEDURES WITH CC
|
Facility
|
IP
|
$31,582.17
|
|
|
Service Code
|
MSDRG 501
|
| Min. Negotiated Rate |
$4,414.55 |
| Max. Negotiated Rate |
$31,582.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,414.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,456.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,414.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,054.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,577.75
|
| Rate for Payer: GEHA Medicare |
$18,577.75
|
| Rate for Payer: Humana ChoiceCare |
$20,435.53
|
| Rate for Payer: Humana Medicare Advantage |
$18,577.75
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,210.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,054.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,577.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31,582.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,008.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,054.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,577.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26,566.18
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,206.19
|
| Rate for Payer: United Healthcare Commercial |
$12,171.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,054.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,577.75
|
| Rate for Payer: Zelis Medicare |
$15,791.09
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,689.78
|
|
|
MS-DRG 42.00: SOFT TISSUE PROCEDURES WITH MCC
|
Facility
|
IP
|
$56,073.53
|
|
|
Service Code
|
MSDRG 500
|
| Min. Negotiated Rate |
$8,411.55 |
| Max. Negotiated Rate |
$56,073.53 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,411.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,666.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,411.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,110.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$32,984.43
|
| Rate for Payer: GEHA Medicare |
$32,984.43
|
| Rate for Payer: Humana ChoiceCare |
$36,282.87
|
| Rate for Payer: Humana Medicare Advantage |
$32,984.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$55,413.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,110.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$32,984.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$56,073.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$46,178.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,110.90
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$32,984.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$47,167.73
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$32,324.74
|
| Rate for Payer: United Healthcare Commercial |
$21,610.53
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,110.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,984.43
|
| Rate for Payer: Zelis Medicare |
$28,036.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,754.99
|
|
|
MS-DRG 42.00: SOFT TISSUE PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,724.95
|
|
|
Service Code
|
MSDRG 502
|
| Min. Negotiated Rate |
$3,228.05 |
| Max. Negotiated Rate |
$24,724.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,228.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,317.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,228.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,960.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,544.09
|
| Rate for Payer: GEHA Medicare |
$14,544.09
|
| Rate for Payer: Humana ChoiceCare |
$15,998.50
|
| Rate for Payer: Humana Medicare Advantage |
$14,544.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,434.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,960.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,544.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,724.95
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,361.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,960.26
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,544.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,798.05
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,253.21
|
| Rate for Payer: United Healthcare Commercial |
$9,528.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,960.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,544.09
|
| Rate for Payer: Zelis Medicare |
$12,362.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,151.66
|
|
|
MS-DRG 42.00: SPINAL DISORDERS AND INJURIES WITH CC/MCC
|
Facility
|
IP
|
$35,613.32
|
|
|
Service Code
|
MSDRG 052
|
| Min. Negotiated Rate |
$10,801.70 |
| Max. Negotiated Rate |
$35,613.32 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,801.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,301.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,801.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19,330.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,949.01
|
| Rate for Payer: GEHA Medicare |
$20,949.01
|
| Rate for Payer: Humana ChoiceCare |
$23,043.91
|
| Rate for Payer: Humana Medicare Advantage |
$20,949.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$35,194.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19,330.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,949.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,613.32
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,328.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19,330.32
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,949.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,957.08
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,530.03
|
| Rate for Payer: United Healthcare Commercial |
$13,725.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19,330.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,949.01
|
| Rate for Payer: Zelis Medicare |
$17,806.66
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,181.88
|
|
|
MS-DRG 42.00: SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,458.38
|
|
|
Service Code
|
MSDRG 053
|
| Min. Negotiated Rate |
$5,821.20 |
| Max. Negotiated Rate |
$16,458.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,821.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,463.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,821.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,538.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,681.40
|
| Rate for Payer: GEHA Medicare |
$9,681.40
|
| Rate for Payer: Humana ChoiceCare |
$10,649.54
|
| Rate for Payer: Humana Medicare Advantage |
$9,681.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,264.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,538.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,681.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,458.38
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,553.96
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,538.05
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,681.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,844.40
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,487.77
|
| Rate for Payer: United Healthcare Commercial |
$6,283.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,538.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,681.40
|
| Rate for Payer: Zelis Medicare |
$8,229.19
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,035.17
|
|
|
MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC
|
Facility
|
IP
|
$101,564.82
|
|
|
Service Code
|
MSDRG 457
|
| Min. Negotiated Rate |
$21,074.55 |
| Max. Negotiated Rate |
$101,564.82 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$21,074.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$46,489.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$21,074.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$37,465.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$59,744.01
|
| Rate for Payer: GEHA Medicare |
$59,744.01
|
| Rate for Payer: Humana ChoiceCare |
$65,718.41
|
| Rate for Payer: Humana Medicare Advantage |
$59,744.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$100,369.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$37,465.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$59,744.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$101,564.82
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$83,641.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$37,465.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$59,744.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$85,433.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58,549.13
|
| Rate for Payer: United Healthcare Commercial |
$39,142.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$37,465.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59,744.01
|
| Rate for Payer: Zelis Medicare |
$50,782.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$37,593.07
|
|
|
MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC
|
Facility
|
IP
|
$149,871.54
|
|
|
Service Code
|
MSDRG 456
|
| Min. Negotiated Rate |
$26,621.70 |
| Max. Negotiated Rate |
$149,871.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$26,621.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$68,600.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$26,621.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$47,258.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$88,159.73
|
| Rate for Payer: GEHA Medicare |
$88,159.73
|
| Rate for Payer: Humana ChoiceCare |
$96,975.70
|
| Rate for Payer: Humana Medicare Advantage |
$88,159.73
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$148,108.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$47,258.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$88,159.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$149,871.54
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$123,423.62
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$47,258.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$88,159.73
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$126,068.41
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$86,396.54
|
| Rate for Payer: United Healthcare Commercial |
$57,759.94
|
| Rate for Payer: United Healthcare Managed Medicaid |
$47,258.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$88,159.73
|
| Rate for Payer: Zelis Medicare |
$74,935.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$55,473.26
|
|
|
MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$76,411.62
|
|
|
Service Code
|
MSDRG 458
|
| Min. Negotiated Rate |
$16,240.35 |
| Max. Negotiated Rate |
$76,411.62 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,240.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$34,975.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,240.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$28,931.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$44,948.01
|
| Rate for Payer: GEHA Medicare |
$44,948.01
|
| Rate for Payer: Humana ChoiceCare |
$49,442.81
|
| Rate for Payer: Humana Medicare Advantage |
$44,948.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$75,512.66
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$28,931.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$44,948.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$76,411.62
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$62,927.21
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$28,931.39
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$44,948.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$64,275.65
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$44,049.05
|
| Rate for Payer: United Healthcare Commercial |
$29,448.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$28,931.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$44,948.01
|
| Rate for Payer: Zelis Medicare |
$38,205.81
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$28,282.90
|
|
|
MS-DRG 42.00: SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS
|
Facility
|
IP
|
$59,400.41
|
|
|
Service Code
|
MSDRG 029
|
| Min. Negotiated Rate |
$19,555.55 |
| Max. Negotiated Rate |
$59,400.41 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$19,555.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$27,189.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$19,555.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$34,783.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$34,941.42
|
| Rate for Payer: GEHA Medicare |
$34,941.42
|
| Rate for Payer: Humana ChoiceCare |
$38,435.56
|
| Rate for Payer: Humana Medicare Advantage |
$34,941.42
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58,701.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$34,783.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$34,941.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59,400.41
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$48,917.99
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$34,783.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$34,941.42
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$49,966.23
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34,242.59
|
| Rate for Payer: United Healthcare Commercial |
$22,892.69
|
| Rate for Payer: United Healthcare Managed Medicaid |
$34,783.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34,941.42
|
| Rate for Payer: Zelis Medicare |
$29,700.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21,986.38
|
|
|
MS-DRG 42.00: SPINAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$107,583.26
|
|
|
Service Code
|
MSDRG 028
|
| Min. Negotiated Rate |
$20,121.50 |
| Max. Negotiated Rate |
$107,583.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$20,121.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$49,243.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$20,121.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$35,782.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$63,284.27
|
| Rate for Payer: GEHA Medicare |
$63,284.27
|
| Rate for Payer: Humana ChoiceCare |
$69,612.70
|
| Rate for Payer: Humana Medicare Advantage |
$63,284.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$106,317.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$35,782.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$63,284.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$107,583.26
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$88,597.98
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$35,782.94
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$63,284.27
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$90,496.51
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$62,018.58
|
| Rate for Payer: United Healthcare Commercial |
$41,462.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$35,782.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63,284.27
|
| Rate for Payer: Zelis Medicare |
$53,791.63
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$39,820.72
|
|
|
MS-DRG 42.00: SPINAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$39,380.81
|
|
|
Service Code
|
MSDRG 030
|
| Min. Negotiated Rate |
$11,953.20 |
| Max. Negotiated Rate |
$39,380.81 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,953.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,025.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,953.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21,363.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,165.18
|
| Rate for Payer: GEHA Medicare |
$23,165.18
|
| Rate for Payer: Humana ChoiceCare |
$25,481.70
|
| Rate for Payer: Humana Medicare Advantage |
$23,165.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$38,917.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21,363.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,165.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39,380.81
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$32,431.25
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21,363.11
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,165.18
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,126.21
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22,701.88
|
| Rate for Payer: United Healthcare Commercial |
$15,177.23
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21,363.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,165.18
|
| Rate for Payer: Zelis Medicare |
$19,690.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,576.37
|
|
|
MS-DRG 42.00: SPLENIC PROCEDURES WITH CC
|
Facility
|
IP
|
$51,562.82
|
|
|
Service Code
|
MSDRG 800
|
| Min. Negotiated Rate |
$10,503.15 |
| Max. Negotiated Rate |
$51,562.82 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,503.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,601.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,503.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,803.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$30,331.07
|
| Rate for Payer: GEHA Medicare |
$30,331.07
|
| Rate for Payer: Humana ChoiceCare |
$33,364.18
|
| Rate for Payer: Humana Medicare Advantage |
$30,331.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$50,956.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,803.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$30,331.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$51,562.82
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$42,463.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,803.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$30,331.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$43,373.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,724.45
|
| Rate for Payer: United Healthcare Commercial |
$19,872.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,803.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,331.07
|
| Rate for Payer: Zelis Medicare |
$25,781.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19,085.39
|
|
|
MS-DRG 42.00: SPLENIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$84,141.30
|
|
|
Service Code
|
MSDRG 799
|
| Min. Negotiated Rate |
$14,313.25 |
| Max. Negotiated Rate |
$84,141.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,313.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$38,513.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,313.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25,529.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$49,494.88
|
| Rate for Payer: GEHA Medicare |
$49,494.88
|
| Rate for Payer: Humana ChoiceCare |
$54,444.37
|
| Rate for Payer: Humana Medicare Advantage |
$49,494.88
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$83,151.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25,529.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$49,494.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$84,141.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$69,292.83
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25,529.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$49,494.88
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70,777.68
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$48,504.98
|
| Rate for Payer: United Healthcare Commercial |
$32,427.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25,529.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$49,494.88
|
| Rate for Payer: Zelis Medicare |
$42,070.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$31,143.94
|
|
|
MS-DRG 42.00: SPLENIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$29,051.64
|
|
|
Service Code
|
MSDRG 801
|
| Min. Negotiated Rate |
$8,553.65 |
| Max. Negotiated Rate |
$29,051.64 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,553.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,297.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,553.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,361.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,089.20
|
| Rate for Payer: GEHA Medicare |
$17,089.20
|
| Rate for Payer: Humana ChoiceCare |
$18,798.12
|
| Rate for Payer: Humana Medicare Advantage |
$17,089.20
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,709.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,361.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,089.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,051.64
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,924.88
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,361.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,089.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,437.56
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,747.42
|
| Rate for Payer: United Healthcare Commercial |
$11,196.39
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,361.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,089.20
|
| Rate for Payer: Zelis Medicare |
$14,525.82
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,753.14
|
|
|
MS-DRG 42.00: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC
|
Facility
|
IP
|
$16,423.33
|
|
|
Service Code
|
MSDRG 537
|
| Min. Negotiated Rate |
$3,526.25 |
| Max. Negotiated Rate |
$16,423.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,526.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,443.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,526.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,486.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,660.78
|
| Rate for Payer: GEHA Medicare |
$9,660.78
|
| Rate for Payer: Humana ChoiceCare |
$10,626.86
|
| Rate for Payer: Humana Medicare Advantage |
$9,660.78
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,230.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,486.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,660.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,423.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,525.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,486.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,660.78
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,814.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,467.56
|
| Rate for Payer: United Healthcare Commercial |
$6,267.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,486.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,660.78
|
| Rate for Payer: Zelis Medicare |
$8,211.66
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,019.45
|
|
|
MS-DRG 42.00: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC
|
Facility
|
IP
|
$12,807.99
|
|
|
Service Code
|
MSDRG 538
|
| Min. Negotiated Rate |
$2,631.30 |
| Max. Negotiated Rate |
$12,807.99 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,631.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,439.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,631.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,906.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,534.11
|
| Rate for Payer: GEHA Medicare |
$7,534.11
|
| Rate for Payer: Humana ChoiceCare |
$8,287.52
|
| Rate for Payer: Humana Medicare Advantage |
$7,534.11
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12,657.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,906.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,534.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$12,807.99
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,547.75
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,906.79
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,534.11
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,773.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,383.43
|
| Rate for Payer: United Healthcare Commercial |
$4,579.63
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,906.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,534.11
|
| Rate for Payer: Zelis Medicare |
$6,403.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,398.32
|
|
|
MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC
|
Facility
|
IP
|
$42,967.82
|
|
|
Service Code
|
MSDRG 327
|
| Min. Negotiated Rate |
$15,183.35 |
| Max. Negotiated Rate |
$42,967.82 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15,183.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19,667.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15,183.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$27,065.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$25,275.19
|
| Rate for Payer: GEHA Medicare |
$25,275.19
|
| Rate for Payer: Humana ChoiceCare |
$27,802.71
|
| Rate for Payer: Humana Medicare Advantage |
$25,275.19
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$42,462.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$27,065.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$25,275.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$42,967.82
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$35,385.27
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$27,065.43
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$25,275.19
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$36,143.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24,769.69
|
| Rate for Payer: United Healthcare Commercial |
$16,559.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$27,065.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,275.19
|
| Rate for Payer: Zelis Medicare |
$21,483.91
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,904.06
|
|
|
MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$89,878.37
|
|
|
Service Code
|
MSDRG 326
|
| Min. Negotiated Rate |
$18,600.05 |
| Max. Negotiated Rate |
$89,878.37 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$18,600.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$41,139.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$18,600.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$33,097.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$52,869.63
|
| Rate for Payer: GEHA Medicare |
$52,869.63
|
| Rate for Payer: Humana ChoiceCare |
$58,156.59
|
| Rate for Payer: Humana Medicare Advantage |
$52,869.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$88,820.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$33,097.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$52,869.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$89,878.37
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$74,017.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$33,097.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$52,869.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$75,603.57
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$51,812.24
|
| Rate for Payer: United Healthcare Commercial |
$34,638.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$33,097.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$52,869.63
|
| Rate for Payer: Zelis Medicare |
$44,939.19
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33,267.45
|
|
|
MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$28,198.70
|
|
|
Service Code
|
MSDRG 328
|
| Min. Negotiated Rate |
$8,533.00 |
| Max. Negotiated Rate |
$28,198.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,533.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,907.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,533.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,325.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,587.47
|
| Rate for Payer: GEHA Medicare |
$16,587.47
|
| Rate for Payer: Humana ChoiceCare |
$18,246.22
|
| Rate for Payer: Humana Medicare Advantage |
$16,587.47
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,866.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,325.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,587.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,198.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,222.46
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,325.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,587.47
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,720.08
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,255.72
|
| Rate for Payer: United Healthcare Commercial |
$10,867.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,325.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,587.47
|
| Rate for Payer: Zelis Medicare |
$14,099.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,437.42
|
|
|
MS-DRG 42.00: SYNCOPE AND COLLAPSE
|
Facility
|
IP
|
$15,726.56
|
|
|
Service Code
|
MSDRG 312
|
| Min. Negotiated Rate |
$2,782.50 |
| Max. Negotiated Rate |
$15,726.56 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,782.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,057.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,782.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,173.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,250.92
|
| Rate for Payer: GEHA Medicare |
$9,250.92
|
| Rate for Payer: Humana ChoiceCare |
$10,176.01
|
| Rate for Payer: Humana Medicare Advantage |
$9,250.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,541.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,173.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,250.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,726.56
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,951.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,173.71
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,250.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,228.82
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,065.90
|
| Rate for Payer: United Healthcare Commercial |
$5,942.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,173.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,250.92
|
| Rate for Payer: Zelis Medicare |
$7,863.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,707.02
|
|
|
MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITH MCC
|
Facility
|
IP
|
$27,423.60
|
|
|
Service Code
|
MSDRG 557
|
| Min. Negotiated Rate |
$6,403.95 |
| Max. Negotiated Rate |
$27,423.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,403.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,552.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,403.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,566.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,131.53
|
| Rate for Payer: GEHA Medicare |
$16,131.53
|
| Rate for Payer: Humana ChoiceCare |
$17,744.68
|
| Rate for Payer: Humana Medicare Advantage |
$16,131.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,100.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,566.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,131.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,423.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,584.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,566.80
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,131.53
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,068.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,808.90
|
| Rate for Payer: United Healthcare Commercial |
$10,568.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,566.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,131.53
|
| Rate for Payer: Zelis Medicare |
$13,711.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,150.53
|
|
|
MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC
|
Facility
|
IP
|
$15,617.00
|
|
|
Service Code
|
MSDRG 558
|
| Min. Negotiated Rate |
$2,858.45 |
| Max. Negotiated Rate |
$15,617.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,858.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,996.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,858.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,307.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,186.47
|
| Rate for Payer: GEHA Medicare |
$9,186.47
|
| Rate for Payer: Humana ChoiceCare |
$10,105.12
|
| Rate for Payer: Humana Medicare Advantage |
$9,186.47
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,433.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,307.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,186.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,617.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,861.06
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,307.79
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,186.47
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,136.65
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,002.74
|
| Rate for Payer: United Healthcare Commercial |
$5,891.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,307.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,186.47
|
| Rate for Payer: Zelis Medicare |
$7,808.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,657.89
|
|
