|
MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC
|
Facility
|
IP
|
$88,538.75
|
|
|
Service Code
|
MSDRG 278
|
| Min. Negotiated Rate |
$14,647.15 |
| Max. Negotiated Rate |
$88,538.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,647.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40,526.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,647.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26,118.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$52,081.62
|
| Rate for Payer: GEHA Medicare |
$52,081.62
|
| Rate for Payer: Humana ChoiceCare |
$57,289.78
|
| Rate for Payer: Humana Medicare Advantage |
$52,081.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$87,497.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26,118.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$52,081.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$88,538.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$72,914.27
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26,118.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$52,081.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$74,476.72
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$51,039.99
|
| Rate for Payer: United Healthcare Commercial |
$34,122.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26,118.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$52,081.62
|
| Rate for Payer: Zelis Medicare |
$44,269.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$32,771.61
|
|
|
MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC
|
Facility
|
IP
|
$56,705.30
|
|
|
Service Code
|
MSDRG 279
|
| Min. Negotiated Rate |
$10,076.15 |
| Max. Negotiated Rate |
$56,705.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,076.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25,955.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,076.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,049.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$33,356.06
|
| Rate for Payer: GEHA Medicare |
$33,356.06
|
| Rate for Payer: Humana ChoiceCare |
$36,691.67
|
| Rate for Payer: Humana Medicare Advantage |
$33,356.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$56,038.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,049.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$33,356.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$56,705.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$46,698.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,049.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$33,356.06
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$47,699.17
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$32,688.94
|
| Rate for Payer: United Healthcare Commercial |
$21,854.01
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,049.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,356.06
|
| Rate for Payer: Zelis Medicare |
$28,352.65
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,988.82
|
|
|
MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM
|
Facility
|
IP
|
$54,302.13
|
|
|
Service Code
|
MSDRG 173
|
| Min. Negotiated Rate |
$10,072.65 |
| Max. Negotiated Rate |
$54,302.13 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,072.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$24,855.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,072.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,043.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$31,942.43
|
| Rate for Payer: GEHA Medicare |
$31,942.43
|
| Rate for Payer: Humana ChoiceCare |
$35,136.67
|
| Rate for Payer: Humana Medicare Advantage |
$31,942.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$53,663.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,043.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$31,942.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$54,302.13
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$44,719.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,043.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$31,942.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$45,677.67
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$31,303.58
|
| Rate for Payer: United Healthcare Commercial |
$20,927.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,043.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31,942.43
|
| Rate for Payer: Zelis Medicare |
$27,151.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20,099.33
|
|
|
MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$22,371.40
|
|
|
Service Code
|
MSDRG 383
|
| Min. Negotiated Rate |
$4,354.35 |
| Max. Negotiated Rate |
$22,371.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,354.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$10,240.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,354.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,948.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13,159.65
|
| Rate for Payer: GEHA Medicare |
$13,159.65
|
| Rate for Payer: Humana ChoiceCare |
$14,475.61
|
| Rate for Payer: Humana Medicare Advantage |
$13,159.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22,108.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,948.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13,159.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22,371.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$18,423.51
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,948.56
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13,159.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18,818.30
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,896.46
|
| Rate for Payer: United Healthcare Commercial |
$8,621.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,948.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,159.65
|
| Rate for Payer: Zelis Medicare |
$11,185.70
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,280.51
|
|
|
MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITHOUT MCC
|
Facility
|
IP
|
$15,701.71
|
|
|
Service Code
|
MSDRG 384
|
| Min. Negotiated Rate |
$3,125.15 |
| Max. Negotiated Rate |
$15,701.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,125.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,043.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,125.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,778.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,236.30
|
| Rate for Payer: GEHA Medicare |
$9,236.30
|
| Rate for Payer: Humana ChoiceCare |
$10,159.93
|
| Rate for Payer: Humana Medicare Advantage |
$9,236.30
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,516.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,778.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,236.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15,701.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12,930.82
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,778.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,236.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,207.91
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,051.57
|
| Rate for Payer: United Healthcare Commercial |
$5,930.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,778.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,236.30
|
| Rate for Payer: Zelis Medicare |
$7,850.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,695.88
|
|
|
MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC
|
Facility
|
IP
|
$29,971.82
|
|
|
Service Code
|
MSDRG 256
|
| Min. Negotiated Rate |
$8,051.40 |
| Max. Negotiated Rate |
$29,971.82 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,051.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,718.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,051.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,475.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,630.48
|
| Rate for Payer: GEHA Medicare |
$17,630.48
|
| Rate for Payer: Humana ChoiceCare |
$19,393.53
|
| Rate for Payer: Humana Medicare Advantage |
$17,630.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,619.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,475.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,630.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,971.82
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,682.67
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,475.11
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,630.48
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$25,211.59
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,277.87
|
| Rate for Payer: United Healthcare Commercial |
$11,551.03
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,475.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,630.48
|
| Rate for Payer: Zelis Medicare |
$14,985.91
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,093.74
|
|
|
MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC
|
Facility
|
IP
|
$46,301.74
|
|
|
Service Code
|
MSDRG 255
|
| Min. Negotiated Rate |
$13,399.75 |
| Max. Negotiated Rate |
$46,301.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$13,399.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21,193.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$13,399.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23,916.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$27,236.32
|
| Rate for Payer: GEHA Medicare |
$27,236.32
|
| Rate for Payer: Humana ChoiceCare |
$29,959.95
|
| Rate for Payer: Humana Medicare Advantage |
$27,236.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$45,757.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23,916.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$27,236.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46,301.74
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$38,130.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23,916.76
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$27,236.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$38,947.94
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$26,691.59
|
| Rate for Payer: United Healthcare Commercial |
$17,844.53
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23,916.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,236.32
|
| Rate for Payer: Zelis Medicare |
$23,150.87
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17,138.08
|
|
|
MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$16,027.46
|
|
|
Service Code
|
MSDRG 257
|
| Min. Negotiated Rate |
$5,505.85 |
| Max. Negotiated Rate |
$16,027.46 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,505.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,224.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,505.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,981.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,427.92
|
| Rate for Payer: GEHA Medicare |
$9,427.92
|
| Rate for Payer: Humana ChoiceCare |
$10,370.71
|
| Rate for Payer: Humana Medicare Advantage |
$9,427.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15,838.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,981.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,427.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,027.46
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,199.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,981.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,427.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,481.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,239.36
|
| Rate for Payer: United Healthcare Commercial |
$6,082.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,981.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,427.92
|
| Rate for Payer: Zelis Medicare |
$8,013.73
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,841.94
|
|
|
MS-DRG 42.00: URETHRAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$30,502.71
|
|
|
Service Code
|
MSDRG 671
|
| Min. Negotiated Rate |
$3,636.15 |
| Max. Negotiated Rate |
$30,502.71 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,636.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,961.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,636.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,680.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,942.77
|
| Rate for Payer: GEHA Medicare |
$17,942.77
|
| Rate for Payer: Humana ChoiceCare |
$19,737.05
|
| Rate for Payer: Humana Medicare Advantage |
$17,942.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30,143.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,680.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,942.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30,502.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25,119.88
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,680.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,942.77
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$25,658.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,583.91
|
| Rate for Payer: United Healthcare Commercial |
$11,755.63
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,680.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,942.77
|
| Rate for Payer: Zelis Medicare |
$15,251.35
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,290.24
|
|
|
MS-DRG 42.00: URETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,366.57
|
|
|
Service Code
|
MSDRG 672
|
| Min. Negotiated Rate |
$3,501.05 |
| Max. Negotiated Rate |
$19,366.57 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,501.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,864.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,501.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,442.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,392.10
|
| Rate for Payer: GEHA Medicare |
$11,392.10
|
| Rate for Payer: Humana ChoiceCare |
$12,531.31
|
| Rate for Payer: Humana Medicare Advantage |
$11,392.10
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,138.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,442.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,392.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,366.57
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,948.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,442.19
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,392.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,290.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,164.26
|
| Rate for Payer: United Healthcare Commercial |
$7,463.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,442.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,392.10
|
| Rate for Payer: Zelis Medicare |
$9,683.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,168.32
|
|
|
MS-DRG 42.00: URETHRAL STRICTURE
|
Facility
|
IP
|
$17,727.91
|
|
|
Service Code
|
MSDRG 697
|
| Min. Negotiated Rate |
$4,323.90 |
| Max. Negotiated Rate |
$17,727.91 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,323.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,114.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,323.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,894.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10,428.18
|
| Rate for Payer: GEHA Medicare |
$10,428.18
|
| Rate for Payer: Humana ChoiceCare |
$11,471.00
|
| Rate for Payer: Humana Medicare Advantage |
$10,428.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17,519.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,894.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10,428.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17,727.91
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14,599.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,894.80
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10,428.18
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,912.30
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10,219.62
|
| Rate for Payer: United Healthcare Commercial |
$6,832.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,894.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,428.18
|
| Rate for Payer: Zelis Medicare |
$8,863.95
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,561.79
|
|
|
MS-DRG 42.00: URINARY STONES WITH MCC
|
Facility
|
IP
|
$26,020.28
|
|
|
Service Code
|
MSDRG 693
|
| Min. Negotiated Rate |
$3,962.35 |
| Max. Negotiated Rate |
$26,020.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,962.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,910.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,962.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,256.54
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,306.05
|
| Rate for Payer: GEHA Medicare |
$15,306.05
|
| Rate for Payer: Humana ChoiceCare |
$16,836.65
|
| Rate for Payer: Humana Medicare Advantage |
$15,306.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25,714.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,256.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,306.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,020.28
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$21,428.47
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,256.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,306.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$21,887.65
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,999.93
|
| Rate for Payer: United Healthcare Commercial |
$10,028.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,256.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,306.05
|
| Rate for Payer: Zelis Medicare |
$13,010.14
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,631.12
|
|
|
MS-DRG 42.00: URINARY STONES WITHOUT MCC
|
Facility
|
IP
|
$14,413.33
|
|
|
Service Code
|
MSDRG 694
|
| Min. Negotiated Rate |
$2,757.30 |
| Max. Negotiated Rate |
$14,413.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,757.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,329.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,757.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,129.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8,478.43
|
| Rate for Payer: GEHA Medicare |
$8,478.43
|
| Rate for Payer: Humana ChoiceCare |
$9,326.27
|
| Rate for Payer: Humana Medicare Advantage |
$8,478.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14,243.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,129.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8,478.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14,413.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,869.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,129.22
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8,478.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,124.15
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,308.86
|
| Rate for Payer: United Healthcare Commercial |
$5,329.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,129.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,478.43
|
| Rate for Payer: Zelis Medicare |
$7,206.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,118.17
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$32,325.42
|
|
|
Service Code
|
MSDRG 742
|
| Min. Negotiated Rate |
$5,455.45 |
| Max. Negotiated Rate |
$32,325.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,455.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,796.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,455.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,892.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,014.95
|
| Rate for Payer: GEHA Medicare |
$19,014.95
|
| Rate for Payer: Humana ChoiceCare |
$20,916.44
|
| Rate for Payer: Humana Medicare Advantage |
$19,014.95
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,945.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,892.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,014.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,325.42
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,620.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,892.37
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,014.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,191.38
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,634.65
|
| Rate for Payer: United Healthcare Commercial |
$12,458.09
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,892.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,014.95
|
| Rate for Payer: Zelis Medicare |
$16,162.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,964.89
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$21,212.28
|
|
|
Service Code
|
MSDRG 743
|
| Min. Negotiated Rate |
$4,326.70 |
| Max. Negotiated Rate |
$21,212.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,326.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$9,709.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,326.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,899.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,477.81
|
| Rate for Payer: GEHA Medicare |
$12,477.81
|
| Rate for Payer: Humana ChoiceCare |
$13,725.59
|
| Rate for Payer: Humana Medicare Advantage |
$12,477.81
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,962.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,899.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,477.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,212.28
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17,468.93
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,899.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,477.81
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17,843.27
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,228.25
|
| Rate for Payer: United Healthcare Commercial |
$8,175.13
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,899.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,477.81
|
| Rate for Payer: Zelis Medicare |
$10,606.14
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,851.48
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$32,176.77
|
|
|
Service Code
|
MSDRG 740
|
| Min. Negotiated Rate |
$5,568.50 |
| Max. Negotiated Rate |
$32,176.77 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,568.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14,728.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,568.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10,091.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18,927.51
|
| Rate for Payer: GEHA Medicare |
$18,927.51
|
| Rate for Payer: Humana ChoiceCare |
$20,820.26
|
| Rate for Payer: Humana Medicare Advantage |
$18,927.51
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31,798.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$10,091.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18,927.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,176.77
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26,498.51
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$10,091.95
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18,927.51
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27,066.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,548.96
|
| Rate for Payer: United Healthcare Commercial |
$12,400.81
|
| Rate for Payer: United Healthcare Managed Medicaid |
$10,091.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,927.51
|
| Rate for Payer: Zelis Medicare |
$16,088.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,909.86
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$70,446.28
|
|
|
Service Code
|
MSDRG 739
|
| Min. Negotiated Rate |
$7,862.40 |
| Max. Negotiated Rate |
$70,446.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,862.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$32,245.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,862.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14,141.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$41,438.99
|
| Rate for Payer: GEHA Medicare |
$41,438.99
|
| Rate for Payer: Humana ChoiceCare |
$45,582.89
|
| Rate for Payer: Humana Medicare Advantage |
$41,438.99
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$69,617.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14,141.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$41,438.99
|
| Rate for Payer: New Mexico Health Connections Medicare |
$70,446.28
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$58,014.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14,141.46
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$41,438.99
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$59,257.76
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$40,610.21
|
| Rate for Payer: United Healthcare Commercial |
$27,149.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14,141.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41,438.99
|
| Rate for Payer: Zelis Medicare |
$35,223.14
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$26,074.90
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$24,307.33
|
|
|
Service Code
|
MSDRG 741
|
| Min. Negotiated Rate |
$4,390.75 |
| Max. Negotiated Rate |
$24,307.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,390.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$11,126.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,390.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,012.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14,298.43
|
| Rate for Payer: GEHA Medicare |
$14,298.43
|
| Rate for Payer: Humana ChoiceCare |
$15,728.27
|
| Rate for Payer: Humana Medicare Advantage |
$14,298.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24,021.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,012.82
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14,298.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24,307.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20,017.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,012.82
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14,298.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20,446.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14,012.46
|
| Rate for Payer: United Healthcare Commercial |
$9,367.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,012.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,298.43
|
| Rate for Payer: Zelis Medicare |
$12,153.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,997.08
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$35,363.86
|
|
|
Service Code
|
MSDRG 737
|
| Min. Negotiated Rate |
$10,575.95 |
| Max. Negotiated Rate |
$35,363.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10,575.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16,187.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10,575.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$18,931.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$20,802.27
|
| Rate for Payer: GEHA Medicare |
$20,802.27
|
| Rate for Payer: Humana ChoiceCare |
$22,882.50
|
| Rate for Payer: Humana Medicare Advantage |
$20,802.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$34,947.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$18,931.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$20,802.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$35,363.86
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$29,123.18
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$18,931.80
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$20,802.27
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$29,747.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$20,386.22
|
| Rate for Payer: United Healthcare Commercial |
$13,629.09
|
| Rate for Payer: United Healthcare Managed Medicaid |
$18,931.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,802.27
|
| Rate for Payer: Zelis Medicare |
$17,681.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13,089.52
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$69,680.06
|
|
|
Service Code
|
MSDRG 736
|
| Min. Negotiated Rate |
$14,723.45 |
| Max. Negotiated Rate |
$69,680.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,723.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$31,894.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,723.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26,253.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$40,988.27
|
| Rate for Payer: GEHA Medicare |
$40,988.27
|
| Rate for Payer: Humana ChoiceCare |
$45,087.10
|
| Rate for Payer: Humana Medicare Advantage |
$40,988.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$68,860.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26,253.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$40,988.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$69,680.06
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57,383.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26,253.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$40,988.27
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58,613.23
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$40,168.50
|
| Rate for Payer: United Healthcare Commercial |
$26,854.43
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26,253.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40,988.27
|
| Rate for Payer: Zelis Medicare |
$34,840.03
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$25,791.28
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$26,843.17
|
|
|
Service Code
|
MSDRG 738
|
| Min. Negotiated Rate |
$8,354.85 |
| Max. Negotiated Rate |
$26,843.17 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,354.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12,286.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,354.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$15,010.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15,790.10
|
| Rate for Payer: GEHA Medicare |
$15,790.10
|
| Rate for Payer: Humana ChoiceCare |
$17,369.11
|
| Rate for Payer: Humana Medicare Advantage |
$15,790.10
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26,527.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15,010.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15,790.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$26,843.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22,106.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15,010.80
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15,790.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22,579.84
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15,474.30
|
| Rate for Payer: United Healthcare Commercial |
$10,345.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15,010.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,790.10
|
| Rate for Payer: Zelis Medicare |
$13,421.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9,935.69
|
|
|
MS-DRG 42.00: VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$29,633.82
|
|
|
Service Code
|
MSDRG 746
|
| Min. Negotiated Rate |
$5,357.45 |
| Max. Negotiated Rate |
$29,633.82 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,357.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$13,564.26
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,357.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9,719.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17,431.66
|
| Rate for Payer: GEHA Medicare |
$17,431.66
|
| Rate for Payer: Humana ChoiceCare |
$19,174.83
|
| Rate for Payer: Humana Medicare Advantage |
$17,431.66
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29,285.19
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9,719.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17,431.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29,633.82
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24,404.32
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9,719.37
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17,431.66
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,927.27
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17,083.03
|
| Rate for Payer: United Healthcare Commercial |
$11,420.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9,719.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,431.66
|
| Rate for Payer: Zelis Medicare |
$14,816.91
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10,968.63
|
|
|
MS-DRG 42.00: VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,952.11
|
|
|
Service Code
|
MSDRG 747
|
| Min. Negotiated Rate |
$3,893.05 |
| Max. Negotiated Rate |
$16,952.11 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,893.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$7,737.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,893.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,134.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,971.83
|
| Rate for Payer: GEHA Medicare |
$9,971.83
|
| Rate for Payer: Humana ChoiceCare |
$10,969.01
|
| Rate for Payer: Humana Medicare Advantage |
$9,971.83
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,752.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,134.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,971.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,952.11
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,960.56
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,134.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,971.83
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,259.72
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,772.39
|
| Rate for Payer: United Healthcare Commercial |
$6,514.46
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,134.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,971.83
|
| Rate for Payer: Zelis Medicare |
$8,476.06
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,256.56
|
|
|
MS-DRG 42.00: VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$19,400.21
|
|
|
Service Code
|
MSDRG 768
|
| Min. Negotiated Rate |
$3,744.30 |
| Max. Negotiated Rate |
$19,400.21 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,744.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8,880.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,744.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,871.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11,411.89
|
| Rate for Payer: GEHA Medicare |
$11,411.89
|
| Rate for Payer: Humana ChoiceCare |
$12,553.08
|
| Rate for Payer: Humana Medicare Advantage |
$11,411.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19,171.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,871.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11,411.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19,400.21
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,976.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,871.61
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11,411.89
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16,319.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,183.65
|
| Rate for Payer: United Healthcare Commercial |
$7,476.77
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,871.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,411.89
|
| Rate for Payer: Zelis Medicare |
$9,700.11
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,180.77
|
|
|
MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC
|
Facility
|
IP
|
$13,569.01
|
|
|
Service Code
|
MSDRG 806
|
| Min. Negotiated Rate |
$1,685.25 |
| Max. Negotiated Rate |
$13,569.01 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,685.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,861.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,685.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,236.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,981.77
|
| Rate for Payer: GEHA Medicare |
$7,981.77
|
| Rate for Payer: Humana ChoiceCare |
$8,779.95
|
| Rate for Payer: Humana Medicare Advantage |
$7,981.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13,409.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,236.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,981.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13,569.01
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11,174.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,236.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,981.77
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,413.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,822.13
|
| Rate for Payer: United Healthcare Commercial |
$4,934.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,236.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,981.77
|
| Rate for Payer: Zelis Medicare |
$6,784.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,739.58
|
|
