|
SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$15,429.80
|
|
|
Service Code
|
APR-DRG 3122
|
| Min. Negotiated Rate |
$14,695.04 |
| Max. Negotiated Rate |
$15,429.80 |
| Rate for Payer: BCBS Complete |
$15,429.80
|
| Rate for Payer: Mclaren Medicaid |
$14,695.04
|
| Rate for Payer: Meridian Medicaid |
$15,429.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,695.04
|
| Rate for Payer: UHC Medicaid |
$14,695.04
|
| Rate for Payer: UHCCP Medicaid |
$14,695.04
|
|
|
SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$38,383.01
|
|
|
Service Code
|
APR-DRG 3124
|
| Min. Negotiated Rate |
$36,555.25 |
| Max. Negotiated Rate |
$38,383.01 |
| Rate for Payer: BCBS Complete |
$38,383.01
|
| Rate for Payer: Mclaren Medicaid |
$36,555.25
|
| Rate for Payer: Meridian Medicaid |
$38,383.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$36,555.25
|
| Rate for Payer: UHC Medicaid |
$36,555.25
|
| Rate for Payer: UHCCP Medicaid |
$36,555.25
|
|
|
SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$20,287.94
|
|
|
Service Code
|
APR-DRG 3123
|
| Min. Negotiated Rate |
$19,321.85 |
| Max. Negotiated Rate |
$20,287.94 |
| Rate for Payer: BCBS Complete |
$20,287.94
|
| Rate for Payer: Mclaren Medicaid |
$19,321.85
|
| Rate for Payer: Meridian Medicaid |
$20,287.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,321.85
|
| Rate for Payer: UHC Medicaid |
$19,321.85
|
| Rate for Payer: UHCCP Medicaid |
$19,321.85
|
|
|
SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$10,650.77
|
|
|
Service Code
|
APR-DRG 3121
|
| Min. Negotiated Rate |
$10,143.59 |
| Max. Negotiated Rate |
$10,650.77 |
| Rate for Payer: BCBS Complete |
$10,650.77
|
| Rate for Payer: Mclaren Medicaid |
$10,143.59
|
| Rate for Payer: Meridian Medicaid |
$10,650.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,143.59
|
| Rate for Payer: UHC Medicaid |
$10,143.59
|
| Rate for Payer: UHCCP Medicaid |
$10,143.59
|
|
|
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES
|
Facility
|
IP
|
$12,296.71
|
|
|
Service Code
|
APR-DRG 3611
|
| Min. Negotiated Rate |
$11,711.15 |
| Max. Negotiated Rate |
$12,296.71 |
| Rate for Payer: BCBS Complete |
$12,296.71
|
| Rate for Payer: Mclaren Medicaid |
$11,711.15
|
| Rate for Payer: Meridian Medicaid |
$12,296.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,711.15
|
| Rate for Payer: UHC Medicaid |
$11,711.15
|
| Rate for Payer: UHCCP Medicaid |
$11,711.15
|
|
|
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES
|
Facility
|
IP
|
$16,671.56
|
|
|
Service Code
|
APR-DRG 3612
|
| Min. Negotiated Rate |
$15,877.68 |
| Max. Negotiated Rate |
$16,671.56 |
| Rate for Payer: BCBS Complete |
$16,671.56
|
| Rate for Payer: Mclaren Medicaid |
$15,877.68
|
| Rate for Payer: Meridian Medicaid |
$16,671.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,877.68
|
| Rate for Payer: UHC Medicaid |
$15,877.68
|
| Rate for Payer: UHCCP Medicaid |
$15,877.68
|
|
|
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES
|
Facility
|
IP
|
$35,565.24
|
|
|
Service Code
|
APR-DRG 3614
|
| Min. Negotiated Rate |
$33,871.66 |
| Max. Negotiated Rate |
$35,565.24 |
| Rate for Payer: BCBS Complete |
$35,565.24
|
| Rate for Payer: Mclaren Medicaid |
$33,871.66
|
| Rate for Payer: Meridian Medicaid |
$35,565.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$33,871.66
|
| Rate for Payer: UHC Medicaid |
$33,871.66
|
| Rate for Payer: UHCCP Medicaid |
$33,871.66
|
|
|
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES
|
Facility
|
IP
|
$19,027.83
|
|
|
Service Code
|
APR-DRG 3613
|
| Min. Negotiated Rate |
$18,121.74 |
| Max. Negotiated Rate |
$19,027.83 |
| Rate for Payer: BCBS Complete |
$19,027.83
|
| Rate for Payer: Mclaren Medicaid |
$18,121.74
|
| Rate for Payer: Meridian Medicaid |
$19,027.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,121.74
|
| Rate for Payer: UHC Medicaid |
$18,121.74
|
| Rate for Payer: UHCCP Medicaid |
$18,121.74
|
|
|
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$56,583.82
|
|
|
Service Code
|
MSDRG 574
|
| Min. Negotiated Rate |
$26,036.43 |
| Max. Negotiated Rate |
$56,583.82 |
| Rate for Payer: Aetna Medicare |
$28,503.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,258.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,258.46
|
| Rate for Payer: BCBS MAPPO |
$27,406.77
|
| Rate for Payer: BCBS Trust/PPO |
$41,483.66
|
| Rate for Payer: BCN Commercial |
$41,483.66
|
| Rate for Payer: BCN Medicare Advantage |
$27,406.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,406.77
|
| Rate for Payer: Mclaren Medicare |
$27,406.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,777.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,517.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$30,147.45
|
| Rate for Payer: Nomi Health Commercial |
$44,781.06
|
| Rate for Payer: PACE Medicare |
$26,036.43
|
| Rate for Payer: PACE SWMI |
$27,406.77
|
| Rate for Payer: PHP Medicare Advantage |
$27,406.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$55,966.40
|
| Rate for Payer: Priority Health Medicare |
$27,406.77
|
| Rate for Payer: Priority Health Tiered Network |
$44,773.11
|
| Rate for Payer: Railroad Medicare Medicare |
$27,406.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,583.82
|
| Rate for Payer: UHC Core |
$47,339.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27,406.77
|
| Rate for Payer: UHC Exchange |
$38,660.98
|
| Rate for Payer: VA VA |
$27,406.77
|
|
|
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$121,049.79
|
|
|
Service Code
|
MSDRG 573
|
| Min. Negotiated Rate |
$48,649.22 |
| Max. Negotiated Rate |
$121,049.79 |
| Rate for Payer: Aetna Medicare |
$53,258.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64,012.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64,012.14
|
| Rate for Payer: BCBS MAPPO |
$51,209.71
|
| Rate for Payer: BCBS Trust/PPO |
$121,049.79
|
| Rate for Payer: BCN Commercial |
$121,049.79
|
| Rate for Payer: BCN Medicare Advantage |
$51,209.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51,209.71
|
| Rate for Payer: Mclaren Medicare |
$51,209.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53,770.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58,891.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$56,330.68
|
| Rate for Payer: Nomi Health Commercial |
$84,513.06
|
| Rate for Payer: PACE Medicare |
$48,649.22
|
| Rate for Payer: PACE SWMI |
$51,209.71
|
| Rate for Payer: PHP Medicare Advantage |
$51,209.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$105,622.59
|
| Rate for Payer: Priority Health Medicare |
$51,209.71
|
| Rate for Payer: Priority Health Tiered Network |
$84,498.06
|
| Rate for Payer: Railroad Medicare Medicare |
$51,209.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106,787.82
|
| Rate for Payer: UHC Core |
$89,341.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51,209.71
|
| Rate for Payer: UHC Exchange |
$72,962.94
|
| Rate for Payer: VA VA |
$51,209.71
|
|
|
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$28,971.49
|
|
|
Service Code
|
MSDRG 575
|
| Min. Negotiated Rate |
$13,743.29 |
| Max. Negotiated Rate |
$28,971.49 |
| Rate for Payer: Aetna Medicare |
$15,045.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,083.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,083.28
|
| Rate for Payer: BCBS MAPPO |
$14,466.62
|
| Rate for Payer: BCBS Trust/PPO |
$24,920.16
|
| Rate for Payer: BCN Commercial |
$24,920.16
|
| Rate for Payer: BCN Medicare Advantage |
$14,466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,466.62
|
| Rate for Payer: Mclaren Medicare |
$14,466.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,189.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,636.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,913.28
|
| Rate for Payer: Nomi Health Commercial |
$21,073.44
|
| Rate for Payer: PACE Medicare |
$13,743.29
|
| Rate for Payer: PACE SWMI |
$14,466.62
|
| Rate for Payer: PHP Medicare Advantage |
$14,466.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,971.49
|
| Rate for Payer: Priority Health Medicare |
$14,466.62
|
| Rate for Payer: Priority Health Tiered Network |
$23,177.18
|
| Rate for Payer: Railroad Medicare Medicare |
$14,466.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,627.68
|
| Rate for Payer: UHC Core |
$22,277.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,466.62
|
| Rate for Payer: UHC Exchange |
$18,193.40
|
| Rate for Payer: VA VA |
$14,466.62
|
|
|
SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$29,240.57
|
|
|
Service Code
|
MSDRG 623
|
| Min. Negotiated Rate |
$13,720.54 |
| Max. Negotiated Rate |
$29,240.57 |
| Rate for Payer: Aetna Medicare |
$15,020.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,053.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,053.34
|
| Rate for Payer: BCBS MAPPO |
$14,442.67
|
| Rate for Payer: BCBS Trust/PPO |
$27,319.48
|
| Rate for Payer: BCN Commercial |
$27,319.48
|
| Rate for Payer: BCN Medicare Advantage |
$14,442.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,442.67
|
| Rate for Payer: Mclaren Medicare |
$14,442.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,164.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,609.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,886.94
|
| Rate for Payer: Nomi Health Commercial |
$23,141.31
|
| Rate for Payer: PACE Medicare |
$13,720.54
|
| Rate for Payer: PACE SWMI |
$14,442.67
|
| Rate for Payer: PHP Medicare Advantage |
$14,442.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,921.51
|
| Rate for Payer: Priority Health Medicare |
$14,442.67
|
| Rate for Payer: Priority Health Tiered Network |
$23,137.20
|
| Rate for Payer: Railroad Medicare Medicare |
$14,442.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,240.57
|
| Rate for Payer: UHC Core |
$24,463.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,442.67
|
| Rate for Payer: UHC Exchange |
$19,978.66
|
| Rate for Payer: VA VA |
$14,442.67
|
|
|
SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$58,014.96
|
|
|
Service Code
|
MSDRG 622
|
| Min. Negotiated Rate |
$26,681.05 |
| Max. Negotiated Rate |
$58,014.96 |
| Rate for Payer: Aetna Medicare |
$29,208.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,106.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,106.65
|
| Rate for Payer: BCBS MAPPO |
$28,085.32
|
| Rate for Payer: BCBS Trust/PPO |
$40,523.93
|
| Rate for Payer: BCN Commercial |
$40,523.93
|
| Rate for Payer: BCN Medicare Advantage |
$28,085.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,085.32
|
| Rate for Payer: Mclaren Medicare |
$28,085.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,489.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,298.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$30,893.85
|
| Rate for Payer: Nomi Health Commercial |
$45,913.68
|
| Rate for Payer: PACE Medicare |
$26,681.05
|
| Rate for Payer: PACE SWMI |
$28,085.32
|
| Rate for Payer: PHP Medicare Advantage |
$28,085.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57,381.92
|
| Rate for Payer: Priority Health Medicare |
$28,085.32
|
| Rate for Payer: Priority Health Tiered Network |
$45,905.53
|
| Rate for Payer: Railroad Medicare Medicare |
$28,085.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,014.96
|
| Rate for Payer: UHC Core |
$48,536.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28,085.32
|
| Rate for Payer: UHC Exchange |
$39,638.81
|
| Rate for Payer: VA VA |
$28,085.32
|
|
|
SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$20,405.97
|
|
|
Service Code
|
MSDRG 624
|
| Min. Negotiated Rate |
$9,741.25 |
| Max. Negotiated Rate |
$20,405.97 |
| Rate for Payer: Aetna Medicare |
$10,664.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,817.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,817.44
|
| Rate for Payer: BCBS MAPPO |
$10,253.95
|
| Rate for Payer: BCBS Trust/PPO |
$19,557.38
|
| Rate for Payer: BCN Commercial |
$19,557.38
|
| Rate for Payer: BCN Medicare Advantage |
$10,253.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,253.95
|
| Rate for Payer: Mclaren Medicare |
$10,253.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,766.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,792.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,279.34
|
| Rate for Payer: Nomi Health Commercial |
$16,149.51
|
| Rate for Payer: PACE Medicare |
$9,741.25
|
| Rate for Payer: PACE SWMI |
$10,253.95
|
| Rate for Payer: PHP Medicare Advantage |
$10,253.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,183.31
|
| Rate for Payer: Priority Health Medicare |
$10,253.95
|
| Rate for Payer: Priority Health Tiered Network |
$16,146.64
|
| Rate for Payer: Railroad Medicare Medicare |
$10,253.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,405.97
|
| Rate for Payer: UHC Core |
$17,072.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,253.95
|
| Rate for Payer: UHC Exchange |
$13,942.41
|
| Rate for Payer: VA VA |
$10,253.95
|
|
|
SKIN GRAFTS FOR INJURIES WITH CC/MCC
|
Facility
|
IP
|
$59,871.53
|
|
|
Service Code
|
MSDRG 904
|
| Min. Negotiated Rate |
$27,517.26 |
| Max. Negotiated Rate |
$59,871.53 |
| Rate for Payer: Aetna Medicare |
$30,124.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,206.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,206.93
|
| Rate for Payer: BCBS MAPPO |
$28,965.54
|
| Rate for Payer: BCBS Trust/PPO |
$59,107.54
|
| Rate for Payer: BCN Commercial |
$59,107.54
|
| Rate for Payer: BCN Medicare Advantage |
$28,965.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,965.54
|
| Rate for Payer: Mclaren Medicare |
$28,965.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,413.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,310.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$31,862.09
|
| Rate for Payer: Nomi Health Commercial |
$47,382.99
|
| Rate for Payer: PACE Medicare |
$27,517.26
|
| Rate for Payer: PACE SWMI |
$28,965.54
|
| Rate for Payer: PHP Medicare Advantage |
$28,965.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,218.23
|
| Rate for Payer: Priority Health Medicare |
$28,965.54
|
| Rate for Payer: Priority Health Tiered Network |
$47,374.58
|
| Rate for Payer: Railroad Medicare Medicare |
$28,965.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59,871.53
|
| Rate for Payer: UHC Core |
$50,090.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28,965.54
|
| Rate for Payer: UHC Exchange |
$40,907.31
|
| Rate for Payer: VA VA |
$28,965.54
|
|
|
SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$26,397.20
|
|
|
Service Code
|
MSDRG 905
|
| Min. Negotiated Rate |
$11,440.90 |
| Max. Negotiated Rate |
$26,397.20 |
| Rate for Payer: Aetna Medicare |
$12,524.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,053.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,053.81
|
| Rate for Payer: BCBS MAPPO |
$12,043.05
|
| Rate for Payer: BCBS Trust/PPO |
$26,397.20
|
| Rate for Payer: BCN Commercial |
$26,397.20
|
| Rate for Payer: BCN Medicare Advantage |
$12,043.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,043.05
|
| Rate for Payer: Mclaren Medicare |
$12,043.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,645.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,849.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,247.35
|
| Rate for Payer: Nomi Health Commercial |
$18,470.22
|
| Rate for Payer: PACE Medicare |
$11,440.90
|
| Rate for Payer: PACE SWMI |
$12,043.05
|
| Rate for Payer: PHP Medicare Advantage |
$12,043.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,915.58
|
| Rate for Payer: Priority Health Medicare |
$12,043.05
|
| Rate for Payer: Priority Health Tiered Network |
$19,132.46
|
| Rate for Payer: Railroad Medicare Medicare |
$12,043.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,338.34
|
| Rate for Payer: UHC Core |
$19,525.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,043.05
|
| Rate for Payer: UHC Exchange |
$15,945.96
|
| Rate for Payer: VA VA |
$12,043.05
|
|
|
SKIN ULCERS
|
Facility
|
IP
|
$8,053.15
|
|
|
Service Code
|
APR-DRG 3804
|
| Min. Negotiated Rate |
$7,669.66 |
| Max. Negotiated Rate |
$8,053.15 |
| Rate for Payer: BCBS Complete |
$8,053.15
|
| Rate for Payer: Mclaren Medicaid |
$7,669.66
|
| Rate for Payer: Meridian Medicaid |
$8,053.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,669.66
|
| Rate for Payer: UHC Medicaid |
$7,669.66
|
| Rate for Payer: UHCCP Medicaid |
$7,669.66
|
|
|
SKIN ULCERS
|
Facility
|
IP
|
$4,813.43
|
|
|
Service Code
|
APR-DRG 3802
|
| Min. Negotiated Rate |
$4,584.22 |
| Max. Negotiated Rate |
$4,813.43 |
| Rate for Payer: BCBS Complete |
$4,813.43
|
| Rate for Payer: Mclaren Medicaid |
$4,584.22
|
| Rate for Payer: Meridian Medicaid |
$4,813.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,584.22
|
| Rate for Payer: UHC Medicaid |
$4,584.22
|
| Rate for Payer: UHCCP Medicaid |
$4,584.22
|
|
|
SKIN ULCERS
|
Facility
|
IP
|
$3,328.01
|
|
|
Service Code
|
APR-DRG 3801
|
| Min. Negotiated Rate |
$3,169.53 |
| Max. Negotiated Rate |
$3,328.01 |
| Rate for Payer: BCBS Complete |
$3,328.01
|
| Rate for Payer: Mclaren Medicaid |
$3,169.53
|
| Rate for Payer: Meridian Medicaid |
$3,328.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,169.53
|
| Rate for Payer: UHC Medicaid |
$3,169.53
|
| Rate for Payer: UHCCP Medicaid |
$3,169.53
|
|
|
SKIN ULCERS
|
Facility
|
IP
|
$5,954.87
|
|
|
Service Code
|
APR-DRG 3803
|
| Min. Negotiated Rate |
$5,671.30 |
| Max. Negotiated Rate |
$5,954.87 |
| Rate for Payer: BCBS Complete |
$5,954.87
|
| Rate for Payer: Mclaren Medicaid |
$5,671.30
|
| Rate for Payer: Meridian Medicaid |
$5,954.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,671.30
|
| Rate for Payer: UHC Medicaid |
$5,671.30
|
| Rate for Payer: UHCCP Medicaid |
$5,671.30
|
|
|
SKIN ULCERS WITH CC
|
Facility
|
IP
|
$19,336.69
|
|
|
Service Code
|
MSDRG 593
|
| Min. Negotiated Rate |
$9,259.65 |
| Max. Negotiated Rate |
$19,336.69 |
| Rate for Payer: Aetna Medicare |
$10,136.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,183.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,183.75
|
| Rate for Payer: BCBS MAPPO |
$9,747.00
|
| Rate for Payer: BCBS Trust/PPO |
$14,814.92
|
| Rate for Payer: BCN Commercial |
$14,814.92
|
| Rate for Payer: BCN Medicare Advantage |
$9,747.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,747.00
|
| Rate for Payer: Mclaren Medicare |
$9,747.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,234.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,209.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,721.70
|
| Rate for Payer: Nomi Health Commercial |
$15,303.27
|
| Rate for Payer: PACE Medicare |
$9,259.65
|
| Rate for Payer: PACE SWMI |
$9,747.00
|
| Rate for Payer: PHP Medicare Advantage |
$9,747.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,125.69
|
| Rate for Payer: Priority Health Medicare |
$9,747.00
|
| Rate for Payer: Priority Health Tiered Network |
$15,300.55
|
| Rate for Payer: Railroad Medicare Medicare |
$9,747.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,336.69
|
| Rate for Payer: UHC Core |
$16,177.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,747.00
|
| Rate for Payer: UHC Exchange |
$13,211.82
|
| Rate for Payer: VA VA |
$9,747.00
|
|
|
SKIN ULCERS WITH MCC
|
Facility
|
IP
|
$31,545.39
|
|
|
Service Code
|
MSDRG 592
|
| Min. Negotiated Rate |
$14,758.67 |
| Max. Negotiated Rate |
$31,545.39 |
| Rate for Payer: Priority Health Medicare |
$15,535.44
|
| Rate for Payer: Aetna Medicare |
$16,156.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,419.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,419.30
|
| Rate for Payer: BCBS MAPPO |
$15,535.44
|
| Rate for Payer: BCBS Trust/PPO |
$24,842.91
|
| Rate for Payer: BCN Commercial |
$24,842.91
|
| Rate for Payer: BCN Medicare Advantage |
$15,535.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,535.44
|
| Rate for Payer: Mclaren Medicare |
$15,535.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,312.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,865.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,088.98
|
| Rate for Payer: Nomi Health Commercial |
$24,965.37
|
| Rate for Payer: PACE Medicare |
$14,758.67
|
| Rate for Payer: PACE SWMI |
$15,535.44
|
| Rate for Payer: PHP Medicare Advantage |
$15,535.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31,201.18
|
| Rate for Payer: Priority Health Tiered Network |
$24,960.94
|
| Rate for Payer: Railroad Medicare Medicare |
$15,535.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,545.39
|
| Rate for Payer: UHC Core |
$26,391.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,535.44
|
| Rate for Payer: UHC Exchange |
$21,553.44
|
| Rate for Payer: VA VA |
$15,535.44
|
|
|
SKIN ULCERS WITHOUT CC/MCC
|
Facility
|
IP
|
$14,128.84
|
|
|
Service Code
|
MSDRG 594
|
| Min. Negotiated Rate |
$6,913.95 |
| Max. Negotiated Rate |
$14,128.84 |
| Rate for Payer: Aetna Medicare |
$7,568.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,097.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,097.30
|
| Rate for Payer: BCBS MAPPO |
$7,277.84
|
| Rate for Payer: BCBS Trust/PPO |
$9,641.76
|
| Rate for Payer: BCN Commercial |
$9,641.76
|
| Rate for Payer: BCN Medicare Advantage |
$7,277.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,277.84
|
| Rate for Payer: Mclaren Medicare |
$7,277.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,641.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,369.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,005.62
|
| Rate for Payer: Nomi Health Commercial |
$11,181.72
|
| Rate for Payer: PACE Medicare |
$6,913.95
|
| Rate for Payer: PACE SWMI |
$7,277.84
|
| Rate for Payer: PHP Medicare Advantage |
$7,277.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13,974.67
|
| Rate for Payer: Priority Health Medicare |
$7,277.84
|
| Rate for Payer: Priority Health Tiered Network |
$11,179.74
|
| Rate for Payer: Railroad Medicare Medicare |
$7,277.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,128.84
|
| Rate for Payer: UHC Core |
$11,820.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,277.84
|
| Rate for Payer: UHC Exchange |
$9,653.55
|
| Rate for Payer: VA VA |
$7,277.84
|
|
|
SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC)
|
Facility
|
OP
|
$16,119.31
|
|
|
Service Code
|
CPT 57288
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,606.87 |
| Max. Negotiated Rate |
$16,119.31 |
| Rate for Payer: Aetna Medicare |
$5,183.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,230.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,230.57
|
| Rate for Payer: BCBS Complete |
$2,737.47
|
| Rate for Payer: BCBS MAPPO |
$4,984.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,463.60
|
| Rate for Payer: BCN Commercial |
$3,463.60
|
| Rate for Payer: BCN Medicare Advantage |
$4,984.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,984.46
|
| Rate for Payer: Mclaren Medicaid |
$2,606.87
|
| Rate for Payer: Mclaren Medicare |
$4,984.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,233.68
|
| Rate for Payer: Meridian Medicaid |
$5,233.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,732.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,482.91
|
| Rate for Payer: Nomi Health Commercial |
$14,953.38
|
| Rate for Payer: PACE Medicare |
$4,735.24
|
| Rate for Payer: PACE SWMI |
$4,984.46
|
| Rate for Payer: PHP Medicare Advantage |
$4,984.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,606.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,119.31
|
| Rate for Payer: Priority Health Medicare |
$4,984.46
|
| Rate for Payer: Priority Health Tiered Network |
$12,895.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4,984.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,984.46
|
| Rate for Payer: UHC Medicaid |
$2,606.87
|
| Rate for Payer: UHCCP Medicaid |
$2,606.87
|
| Rate for Payer: VA VA |
$4,984.46
|
|
|
SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); EXCEPT NEWBORN
|
Facility
|
OP
|
$6,735.82
|
|
|
Service Code
|
CPT 54001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.19
|
| Rate for Payer: BCN Commercial |
$1,096.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Mclaren Medicaid |
$1,089.34
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
