|
MS-DRG 42.00: TESTES PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$33,810.09
|
|
|
Service Code
|
MSDRG 711
|
| Min. Negotiated Rate |
$5,408.20 |
| Max. Negotiated Rate |
$33,810.09 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,408.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15,475.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,408.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,808.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,888.29
|
| Rate for Payer: GEHA Medicare |
$19,888.29
|
| Rate for Payer: Humana ChoiceCare |
$21,877.12
|
| Rate for Payer: Humana Medicare Advantage |
$19,888.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$33,412.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,808.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,888.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$33,810.09
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$27,843.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,808.96
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,888.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28,440.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$19,490.52
|
| Rate for Payer: United Healthcare Commercial |
$13,030.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,808.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,888.29
|
| Rate for Payer: Zelis Medicare |
$16,905.05
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12,514.43
|
|
|
MS-DRG 42.00: TESTES PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,927.72
|
|
|
Service Code
|
MSDRG 712
|
| Min. Negotiated Rate |
$4,005.05 |
| Max. Negotiated Rate |
$18,927.72 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,005.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,663.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,005.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,331.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,133.95
|
| Rate for Payer: GEHA Medicare |
$11,133.95
|
| Rate for Payer: Humana ChoiceCare |
$12,247.34
|
| Rate for Payer: Humana Medicare Advantage |
$11,133.95
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$18,705.04
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,331.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,133.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18,927.72
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,587.53
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,331.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,133.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15,921.55
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,911.27
|
| Rate for Payer: United Healthcare Commercial |
$7,294.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,331.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,133.95
|
| Rate for Payer: Zelis Medicare |
$9,463.86
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,005.88
|
|
|
MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC
|
Facility
|
IP
|
$26,708.68
|
|
|
Service Code
|
MSDRG 626
|
| Min. Negotiated Rate |
$5,076.75 |
| Max. Negotiated Rate |
$26,708.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,076.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,225.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,076.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,223.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,710.99
|
| Rate for Payer: GEHA Medicare |
$15,710.99
|
| Rate for Payer: Humana ChoiceCare |
$17,282.09
|
| Rate for Payer: Humana Medicare Advantage |
$15,710.99
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,394.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,223.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,710.99
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,708.68
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,995.39
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,223.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,710.99
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,466.72
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,396.77
|
| Rate for Payer: United Healthcare Commercial |
$10,293.43
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,223.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,710.99
|
| Rate for Payer: Zelis Medicare |
$13,354.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,885.92
|
|
|
MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$50,736.42
|
|
|
Service Code
|
MSDRG 625
|
| Min. Negotiated Rate |
$6,567.05 |
| Max. Negotiated Rate |
$50,736.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,567.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,223.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,567.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,854.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29,844.95
|
| Rate for Payer: GEHA Medicare |
$29,844.95
|
| Rate for Payer: Humana ChoiceCare |
$32,829.44
|
| Rate for Payer: Humana Medicare Advantage |
$29,844.95
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$50,139.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,854.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29,844.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$50,736.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$41,782.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,854.73
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29,844.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$42,678.28
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,248.05
|
| Rate for Payer: United Healthcare Commercial |
$19,553.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,854.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,844.95
|
| Rate for Payer: Zelis Medicare |
$25,368.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18,779.51
|
|
|
MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,419.16
|
|
|
Service Code
|
MSDRG 627
|
| Min. Negotiated Rate |
$3,994.20 |
| Max. Negotiated Rate |
$22,419.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,994.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,261.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,994.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,312.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,187.74
|
| Rate for Payer: GEHA Medicare |
$13,187.74
|
| Rate for Payer: Humana ChoiceCare |
$14,506.51
|
| Rate for Payer: Humana Medicare Advantage |
$13,187.74
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,155.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,312.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,187.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,419.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,462.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,312.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,187.74
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,858.47
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,923.99
|
| Rate for Payer: United Healthcare Commercial |
$8,640.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,312.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,187.74
|
| Rate for Payer: Zelis Medicare |
$11,209.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,298.19
|
|
|
MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC
|
Facility
|
IP
|
$72,619.38
|
|
|
Service Code
|
MSDRG 012
|
| Min. Negotiated Rate |
$15,220.80 |
| Max. Negotiated Rate |
$72,619.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15,220.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33,239.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15,220.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$27,131.54
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$42,717.28
|
| Rate for Payer: GEHA Medicare |
$42,717.28
|
| Rate for Payer: Humana ChoiceCare |
$46,989.01
|
| Rate for Payer: Humana Medicare Advantage |
$42,717.28
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$71,765.03
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$27,131.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$42,717.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$72,619.38
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$59,804.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$27,131.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$42,717.28
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$61,085.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$41,862.93
|
| Rate for Payer: United Healthcare Commercial |
$27,987.23
|
| Rate for Payer: United Healthcare Managed Medicaid |
$27,131.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42,717.28
|
| Rate for Payer: Zelis Medicare |
$36,309.69
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$26,879.24
|
|
|
MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC
|
Facility
|
IP
|
$95,486.21
|
|
|
Service Code
|
MSDRG 011
|
| Min. Negotiated Rate |
$26,976.95 |
| Max. Negotiated Rate |
$95,486.21 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$26,976.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$43,706.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$26,976.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$47,885.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56,168.36
|
| Rate for Payer: GEHA Medicare |
$56,168.36
|
| Rate for Payer: Humana ChoiceCare |
$61,785.20
|
| Rate for Payer: Humana Medicare Advantage |
$56,168.36
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$94,362.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$47,885.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56,168.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$95,486.21
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$78,635.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$47,885.14
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56,168.36
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$80,320.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55,044.99
|
| Rate for Payer: United Healthcare Commercial |
$36,800.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$47,885.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56,168.36
|
| Rate for Payer: Zelis Medicare |
$47,743.11
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35,343.14
|
|
|
MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$46,894.58
|
|
|
Service Code
|
MSDRG 013
|
| Min. Negotiated Rate |
$11,378.50 |
| Max. Negotiated Rate |
$46,894.58 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,378.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21,465.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,378.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20,348.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$27,585.05
|
| Rate for Payer: GEHA Medicare |
$27,585.05
|
| Rate for Payer: Humana ChoiceCare |
$30,343.56
|
| Rate for Payer: Humana Medicare Advantage |
$27,585.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$46,342.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20,348.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$27,585.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46,894.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$38,619.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20,348.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$27,585.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$39,446.62
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27,033.35
|
| Rate for Payer: United Healthcare Commercial |
$18,073.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20,348.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,585.05
|
| Rate for Payer: Zelis Medicare |
$23,447.29
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,357.50
|
|
|
MS-DRG 42.00: TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES
|
Facility
|
IP
|
$250,045.45
|
|
|
Service Code
|
MSDRG 004
|
| Min. Negotiated Rate |
$67,939.20 |
| Max. Negotiated Rate |
$250,045.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$67,939.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$114,453.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$67,939.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$120,197.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$147,085.56
|
| Rate for Payer: GEHA Medicare |
$147,085.56
|
| Rate for Payer: Humana ChoiceCare |
$161,794.12
|
| Rate for Payer: Humana Medicare Advantage |
$147,085.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$247,103.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$120,197.44
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$147,085.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$250,045.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$205,919.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$120,197.44
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$147,085.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$210,332.35
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$144,143.85
|
| Rate for Payer: United Healthcare Commercial |
$96,366.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$120,197.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$147,085.56
|
| Rate for Payer: Zelis Medicare |
$125,022.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$92,551.50
|
|
|
MS-DRG 42.00: TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC
|
Facility
|
IP
|
$14,686.49
|
|
|
Service Code
|
MSDRG 069
|
| Min. Negotiated Rate |
$4,562.95 |
| Max. Negotiated Rate |
$14,686.49 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,562.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,480.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,562.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,316.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,639.11
|
| Rate for Payer: GEHA Medicare |
$8,639.11
|
| Rate for Payer: Humana ChoiceCare |
$9,503.02
|
| Rate for Payer: Humana Medicare Advantage |
$8,639.11
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,513.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,316.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,639.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,686.49
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,094.75
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,316.81
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,639.11
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,353.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,466.33
|
| Rate for Payer: United Healthcare Commercial |
$5,456.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,316.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,639.11
|
| Rate for Payer: Zelis Medicare |
$7,343.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,240.65
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH CC
|
Facility
|
IP
|
$27,384.65
|
|
|
Service Code
|
MSDRG 669
|
| Min. Negotiated Rate |
$4,070.50 |
| Max. Negotiated Rate |
$27,384.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,070.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,534.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,070.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,447.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,108.62
|
| Rate for Payer: GEHA Medicare |
$16,108.62
|
| Rate for Payer: Humana ChoiceCare |
$17,719.48
|
| Rate for Payer: Humana Medicare Advantage |
$16,108.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$27,062.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,447.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,108.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27,384.65
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,552.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,447.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,108.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23,035.33
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,786.45
|
| Rate for Payer: United Healthcare Commercial |
$10,553.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,447.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,108.62
|
| Rate for Payer: Zelis Medicare |
$13,692.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,136.12
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$51,607.05
|
|
|
Service Code
|
MSDRG 668
|
| Min. Negotiated Rate |
$6,519.45 |
| Max. Negotiated Rate |
$51,607.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,519.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$23,622.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,519.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,770.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$30,357.09
|
| Rate for Payer: GEHA Medicare |
$30,357.09
|
| Rate for Payer: Humana ChoiceCare |
$33,392.80
|
| Rate for Payer: Humana Medicare Advantage |
$30,357.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$50,999.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11,770.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$30,357.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$51,607.05
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$42,499.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,770.70
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$30,357.09
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$43,410.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$29,749.95
|
| Rate for Payer: United Healthcare Commercial |
$19,889.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,770.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,357.09
|
| Rate for Payer: Zelis Medicare |
$25,803.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19,101.76
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,959.42
|
|
|
Service Code
|
MSDRG 670
|
| Min. Negotiated Rate |
$3,593.45 |
| Max. Negotiated Rate |
$16,959.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,593.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,741.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,593.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,605.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,976.13
|
| Rate for Payer: GEHA Medicare |
$9,976.13
|
| Rate for Payer: Humana ChoiceCare |
$10,973.74
|
| Rate for Payer: Humana Medicare Advantage |
$9,976.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,759.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,605.31
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,976.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,959.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,966.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,605.31
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,976.13
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,265.87
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,776.61
|
| Rate for Payer: United Healthcare Commercial |
$6,517.87
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,605.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,976.13
|
| Rate for Payer: Zelis Medicare |
$8,479.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,259.84
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITH CC/MCC
|
Facility
|
IP
|
$25,588.52
|
|
|
Service Code
|
MSDRG 713
|
| Min. Negotiated Rate |
$5,250.70 |
| Max. Negotiated Rate |
$25,588.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,250.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,712.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,250.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,530.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,052.07
|
| Rate for Payer: GEHA Medicare |
$15,052.07
|
| Rate for Payer: Humana ChoiceCare |
$16,557.28
|
| Rate for Payer: Humana Medicare Advantage |
$15,052.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,287.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,530.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,052.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25,588.52
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,072.90
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,530.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,052.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,524.46
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,751.03
|
| Rate for Payer: United Healthcare Commercial |
$9,861.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,530.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,052.07
|
| Rate for Payer: Zelis Medicare |
$12,794.26
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,471.30
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$16,725.72
|
|
|
Service Code
|
MSDRG 714
|
| Min. Negotiated Rate |
$3,937.15 |
| Max. Negotiated Rate |
$16,725.72 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,937.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,611.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,937.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,212.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,838.66
|
| Rate for Payer: GEHA Medicare |
$9,838.66
|
| Rate for Payer: Humana ChoiceCare |
$10,822.53
|
| Rate for Payer: Humana Medicare Advantage |
$9,838.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,528.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,212.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,838.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,725.72
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,774.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,212.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,838.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,069.28
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,641.89
|
| Rate for Payer: United Healthcare Commercial |
$6,408.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,212.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,838.66
|
| Rate for Payer: Zelis Medicare |
$8,362.86
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,155.03
|
|
|
MS-DRG 42.00: TRAUMATIC INJURY WITH MCC
|
Facility
|
IP
|
$28,637.55
|
|
|
Service Code
|
MSDRG 913
|
| Min. Negotiated Rate |
$3,859.10 |
| Max. Negotiated Rate |
$28,637.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,859.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,108.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,859.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,074.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16,845.62
|
| Rate for Payer: GEHA Medicare |
$16,845.62
|
| Rate for Payer: Humana ChoiceCare |
$18,530.18
|
| Rate for Payer: Humana Medicare Advantage |
$16,845.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28,300.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,074.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16,845.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28,637.55
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23,583.87
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,074.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16,845.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,089.24
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16,508.71
|
| Rate for Payer: United Healthcare Commercial |
$11,036.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,074.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,845.62
|
| Rate for Payer: Zelis Medicare |
$14,318.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,599.86
|
|
|
MS-DRG 42.00: TRAUMATIC INJURY WITHOUT MCC
|
Facility
|
IP
|
$16,385.37
|
|
|
Service Code
|
MSDRG 914
|
| Min. Negotiated Rate |
$2,874.20 |
| Max. Negotiated Rate |
$16,385.37 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,874.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,422.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,874.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,335.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,638.45
|
| Rate for Payer: GEHA Medicare |
$9,638.45
|
| Rate for Payer: Humana ChoiceCare |
$10,602.30
|
| Rate for Payer: Humana Medicare Advantage |
$9,638.45
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,192.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,335.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,638.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,385.37
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,493.83
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,335.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,638.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,782.98
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,445.68
|
| Rate for Payer: United Healthcare Commercial |
$6,249.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,335.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,638.45
|
| Rate for Payer: Zelis Medicare |
$8,192.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,002.42
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC
|
Facility
|
IP
|
$23,210.17
|
|
|
Service Code
|
MSDRG 086
|
| Min. Negotiated Rate |
$5,581.80 |
| Max. Negotiated Rate |
$23,210.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,581.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,623.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,581.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,115.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,653.04
|
| Rate for Payer: GEHA Medicare |
$13,653.04
|
| Rate for Payer: Humana ChoiceCare |
$15,018.34
|
| Rate for Payer: Humana Medicare Advantage |
$13,653.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,937.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,115.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,653.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23,210.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19,114.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,115.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,653.04
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,523.85
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13,379.98
|
| Rate for Payer: United Healthcare Commercial |
$8,945.11
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,115.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,653.04
|
| Rate for Payer: Zelis Medicare |
$11,605.08
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,590.98
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC
|
Facility
|
IP
|
$24,604.61
|
|
|
Service Code
|
MSDRG 083
|
| Min. Negotiated Rate |
$9,107.12 |
| Max. Negotiated Rate |
$24,604.61 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,772.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,262.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,772.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21,043.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,473.30
|
| Rate for Payer: GEHA Medicare |
$14,473.30
|
| Rate for Payer: Humana ChoiceCare |
$15,920.63
|
| Rate for Payer: Humana Medicare Advantage |
$14,473.30
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,315.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21,043.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,473.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,604.61
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,262.62
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21,043.67
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,473.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,696.82
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,183.83
|
| Rate for Payer: United Healthcare Commercial |
$9,482.53
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21,043.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,473.30
|
| Rate for Payer: Zelis Medicare |
$12,302.31
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,107.12
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC
|
Facility
|
IP
|
$40,099.29
|
|
|
Service Code
|
MSDRG 085
|
| Min. Negotiated Rate |
$7,775.95 |
| Max. Negotiated Rate |
$40,099.29 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,775.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,354.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,775.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,988.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23,587.82
|
| Rate for Payer: GEHA Medicare |
$23,587.82
|
| Rate for Payer: Humana ChoiceCare |
$25,946.60
|
| Rate for Payer: Humana Medicare Advantage |
$23,587.82
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39,627.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,988.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23,587.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40,099.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$33,022.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,988.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23,587.82
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33,730.58
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,116.06
|
| Rate for Payer: United Healthcare Commercial |
$15,454.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,988.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,587.82
|
| Rate for Payer: Zelis Medicare |
$20,049.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,842.30
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC
|
Facility
|
IP
|
$41,058.42
|
|
|
Service Code
|
MSDRG 082
|
| Min. Negotiated Rate |
$15,197.31 |
| Max. Negotiated Rate |
$41,058.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15,744.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18,793.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15,744.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$28,055.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$24,152.01
|
| Rate for Payer: GEHA Medicare |
$24,152.01
|
| Rate for Payer: Humana ChoiceCare |
$26,567.21
|
| Rate for Payer: Humana Medicare Advantage |
$24,152.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$40,575.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$28,055.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$24,152.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$41,058.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$33,812.81
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$28,055.87
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$24,152.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$34,537.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$23,668.97
|
| Rate for Payer: United Healthcare Commercial |
$15,823.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$28,055.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,152.01
|
| Rate for Payer: Zelis Medicare |
$20,529.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15,197.31
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC
|
Facility
|
IP
|
$15,912.07
|
|
|
Service Code
|
MSDRG 087
|
| Min. Negotiated Rate |
$4,729.55 |
| Max. Negotiated Rate |
$15,912.07 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,729.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,160.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,729.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,610.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,360.04
|
| Rate for Payer: GEHA Medicare |
$9,360.04
|
| Rate for Payer: Humana ChoiceCare |
$10,296.04
|
| Rate for Payer: Humana Medicare Advantage |
$9,360.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,724.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,610.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,360.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,912.07
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,104.06
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,610.91
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,360.04
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,384.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,172.84
|
| Rate for Payer: United Healthcare Commercial |
$6,028.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,610.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,360.04
|
| Rate for Payer: Zelis Medicare |
$7,956.03
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,790.20
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC
|
Facility
|
IP
|
$16,965.25
|
|
|
Service Code
|
MSDRG 084
|
| Min. Negotiated Rate |
$6,262.45 |
| Max. Negotiated Rate |
$16,965.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9,305.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,744.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9,305.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16,689.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,979.56
|
| Rate for Payer: GEHA Medicare |
$9,979.56
|
| Rate for Payer: Humana ChoiceCare |
$10,977.52
|
| Rate for Payer: Humana Medicare Advantage |
$9,979.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,765.66
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16,689.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,979.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,965.25
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,971.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16,689.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,979.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,270.77
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,779.97
|
| Rate for Payer: United Healthcare Commercial |
$6,520.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16,689.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,979.56
|
| Rate for Payer: Zelis Medicare |
$8,482.63
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,262.45
|
|
|
MS-DRG 42.00: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC
|
Facility
|
IP
|
$26,291.04
|
|
|
Service Code
|
MSDRG 604
|
| Min. Negotiated Rate |
$2,775.85 |
| Max. Negotiated Rate |
$26,291.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,775.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,034.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,775.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,161.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,465.32
|
| Rate for Payer: GEHA Medicare |
$15,465.32
|
| Rate for Payer: Humana ChoiceCare |
$17,011.85
|
| Rate for Payer: Humana Medicare Advantage |
$15,465.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,981.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,161.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,465.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,291.04
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,651.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,161.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,465.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,115.41
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,156.01
|
| Rate for Payer: United Healthcare Commercial |
$10,132.47
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,161.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,465.32
|
| Rate for Payer: Zelis Medicare |
$13,145.52
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,731.33
|
|
|
MS-DRG 42.00: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC
|
Facility
|
IP
|
$16,491.97
|
|
|
Service Code
|
MSDRG 605
|
| Min. Negotiated Rate |
$1,900.50 |
| Max. Negotiated Rate |
$16,491.97 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,900.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,481.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,900.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,616.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,701.16
|
| Rate for Payer: GEHA Medicare |
$9,701.16
|
| Rate for Payer: Humana ChoiceCare |
$10,671.28
|
| Rate for Payer: Humana Medicare Advantage |
$9,701.16
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,297.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,616.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,701.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,491.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,581.62
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,616.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,701.16
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,872.66
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,507.14
|
| Rate for Payer: United Healthcare Commercial |
$6,299.63
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,616.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,701.16
|
| Rate for Payer: Zelis Medicare |
$8,245.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,050.23
|
|
