|
APR-DRG 42.00: CLEFT LIP AND PALATE REPAIR
|
Facility
|
IP
|
$5,140.12
|
|
|
Service Code
|
APR-DRG 0951
|
| Min. Negotiated Rate |
$4,895.35 |
| Max. Negotiated Rate |
$5,140.12 |
| Rate for Payer: BCBS Complete |
$5,140.12
|
| Rate for Payer: Mclaren Medicaid |
$4,895.35
|
| Rate for Payer: Meridian Medicaid |
$5,140.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,895.35
|
| Rate for Payer: UHCCP Medicaid |
$5,140.12
|
|
|
APR-DRG 42.00: CLEFT LIP AND PALATE REPAIR
|
Facility
|
IP
|
$8,711.15
|
|
|
Service Code
|
APR-DRG 0953
|
| Min. Negotiated Rate |
$8,296.33 |
| Max. Negotiated Rate |
$8,711.15 |
| Rate for Payer: BCBS Complete |
$8,711.15
|
| Rate for Payer: Mclaren Medicaid |
$8,296.33
|
| Rate for Payer: Meridian Medicaid |
$8,711.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,296.33
|
| Rate for Payer: UHCCP Medicaid |
$8,711.15
|
|
|
APR-DRG 42.00: COAGULATION AND PLATELET DISORDERS
|
Facility
|
IP
|
$8,819.36
|
|
|
Service Code
|
APR-DRG 6613
|
| Min. Negotiated Rate |
$8,399.39 |
| Max. Negotiated Rate |
$8,819.36 |
| Rate for Payer: BCBS Complete |
$8,819.36
|
| Rate for Payer: Mclaren Medicaid |
$8,399.39
|
| Rate for Payer: Meridian Medicaid |
$8,819.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,399.39
|
| Rate for Payer: UHCCP Medicaid |
$8,819.36
|
|
|
APR-DRG 42.00: COAGULATION AND PLATELET DISORDERS
|
Facility
|
IP
|
$4,436.73
|
|
|
Service Code
|
APR-DRG 6611
|
| Min. Negotiated Rate |
$4,225.46 |
| Max. Negotiated Rate |
$4,436.73 |
| Rate for Payer: BCBS Complete |
$4,436.73
|
| Rate for Payer: Mclaren Medicaid |
$4,225.46
|
| Rate for Payer: Meridian Medicaid |
$4,436.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,225.46
|
| Rate for Payer: UHCCP Medicaid |
$4,436.73
|
|
|
APR-DRG 42.00: COAGULATION AND PLATELET DISORDERS
|
Facility
|
IP
|
$14,067.69
|
|
|
Service Code
|
APR-DRG 6614
|
| Min. Negotiated Rate |
$13,397.80 |
| Max. Negotiated Rate |
$14,067.69 |
| Rate for Payer: BCBS Complete |
$14,067.69
|
| Rate for Payer: Mclaren Medicaid |
$13,397.80
|
| Rate for Payer: Meridian Medicaid |
$14,067.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,397.80
|
| Rate for Payer: UHCCP Medicaid |
$14,067.69
|
|
|
APR-DRG 42.00: COAGULATION AND PLATELET DISORDERS
|
Facility
|
IP
|
$6,114.03
|
|
|
Service Code
|
APR-DRG 6612
|
| Min. Negotiated Rate |
$5,822.89 |
| Max. Negotiated Rate |
$6,114.03 |
| Rate for Payer: BCBS Complete |
$6,114.03
|
| Rate for Payer: Mclaren Medicaid |
$5,822.89
|
| Rate for Payer: Meridian Medicaid |
$6,114.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,822.89
|
| Rate for Payer: UHCCP Medicaid |
$6,114.03
|
|
|
APR-DRG 42.00: COCAINE ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$2,543.01
|
|
|
Service Code
|
APR-DRG 7742
|
| Min. Negotiated Rate |
$2,421.91 |
| Max. Negotiated Rate |
$2,543.01 |
| Rate for Payer: BCBS Complete |
$2,543.01
|
| Rate for Payer: Mclaren Medicaid |
$2,421.91
|
| Rate for Payer: Meridian Medicaid |
$2,543.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,421.91
|
| Rate for Payer: UHCCP Medicaid |
$2,543.01
|
|
|
APR-DRG 42.00: COCAINE ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$4,436.73
|
|
|
Service Code
|
APR-DRG 7743
|
| Min. Negotiated Rate |
$4,225.46 |
| Max. Negotiated Rate |
$4,436.73 |
| Rate for Payer: BCBS Complete |
$4,436.73
|
| Rate for Payer: Mclaren Medicaid |
$4,225.46
|
| Rate for Payer: Meridian Medicaid |
$4,436.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,225.46
|
| Rate for Payer: UHCCP Medicaid |
$4,436.73
|
|
|
APR-DRG 42.00: COCAINE ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$1,893.73
|
|
|
Service Code
|
APR-DRG 7741
|
| Min. Negotiated Rate |
$1,803.55 |
| Max. Negotiated Rate |
$1,893.73 |
| Rate for Payer: BCBS Complete |
$1,893.73
|
| Rate for Payer: Mclaren Medicaid |
$1,803.55
|
| Rate for Payer: Meridian Medicaid |
$1,893.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,803.55
|
| Rate for Payer: UHCCP Medicaid |
$1,893.73
|
|
|
APR-DRG 42.00: COCAINE ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$11,037.73
|
|
|
Service Code
|
APR-DRG 7744
|
| Min. Negotiated Rate |
$10,512.12 |
| Max. Negotiated Rate |
$11,037.73 |
| Rate for Payer: BCBS Complete |
$11,037.73
|
| Rate for Payer: Mclaren Medicaid |
$10,512.12
|
| Rate for Payer: Meridian Medicaid |
$11,037.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,512.12
|
| Rate for Payer: UHCCP Medicaid |
$11,037.73
|
|
|
APR-DRG 42.00: CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA
|
Facility
|
IP
|
$5,518.86
|
|
|
Service Code
|
APR-DRG 0572
|
| Min. Negotiated Rate |
$5,256.06 |
| Max. Negotiated Rate |
$5,518.86 |
| Rate for Payer: BCBS Complete |
$5,518.86
|
| Rate for Payer: Mclaren Medicaid |
$5,256.06
|
| Rate for Payer: Meridian Medicaid |
$5,518.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,256.06
|
| Rate for Payer: UHCCP Medicaid |
$5,518.86
|
|
|
APR-DRG 42.00: CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA
|
Facility
|
IP
|
$7,737.23
|
|
|
Service Code
|
APR-DRG 0573
|
| Min. Negotiated Rate |
$7,368.79 |
| Max. Negotiated Rate |
$7,737.23 |
| Rate for Payer: BCBS Complete |
$7,737.23
|
| Rate for Payer: Mclaren Medicaid |
$7,368.79
|
| Rate for Payer: Meridian Medicaid |
$7,737.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,368.79
|
| Rate for Payer: UHCCP Medicaid |
$7,737.23
|
|
|
APR-DRG 42.00: CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA
|
Facility
|
IP
|
$13,039.67
|
|
|
Service Code
|
APR-DRG 0574
|
| Min. Negotiated Rate |
$12,418.73 |
| Max. Negotiated Rate |
$13,039.67 |
| Rate for Payer: BCBS Complete |
$13,039.67
|
| Rate for Payer: Mclaren Medicaid |
$12,418.73
|
| Rate for Payer: Meridian Medicaid |
$13,039.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,418.73
|
| Rate for Payer: UHCCP Medicaid |
$13,039.67
|
|
|
APR-DRG 42.00: CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA
|
Facility
|
IP
|
$3,841.56
|
|
|
Service Code
|
APR-DRG 0571
|
| Min. Negotiated Rate |
$3,658.63 |
| Max. Negotiated Rate |
$3,841.56 |
| Rate for Payer: BCBS Complete |
$3,841.56
|
| Rate for Payer: Mclaren Medicaid |
$3,658.63
|
| Rate for Payer: Meridian Medicaid |
$3,841.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,658.63
|
| Rate for Payer: UHCCP Medicaid |
$3,841.56
|
|
|
APR-DRG 42.00: CONNECTIVE TISSUE DISORDERS
|
Facility
|
IP
|
$8,981.68
|
|
|
Service Code
|
APR-DRG 3463
|
| Min. Negotiated Rate |
$8,553.98 |
| Max. Negotiated Rate |
$8,981.68 |
| Rate for Payer: BCBS Complete |
$8,981.68
|
| Rate for Payer: Mclaren Medicaid |
$8,553.98
|
| Rate for Payer: Meridian Medicaid |
$8,981.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,553.98
|
| Rate for Payer: UHCCP Medicaid |
$8,981.68
|
|
|
APR-DRG 42.00: CONNECTIVE TISSUE DISORDERS
|
Facility
|
IP
|
$4,274.41
|
|
|
Service Code
|
APR-DRG 3461
|
| Min. Negotiated Rate |
$4,070.87 |
| Max. Negotiated Rate |
$4,274.41 |
| Rate for Payer: BCBS Complete |
$4,274.41
|
| Rate for Payer: Mclaren Medicaid |
$4,070.87
|
| Rate for Payer: Meridian Medicaid |
$4,274.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,070.87
|
| Rate for Payer: UHCCP Medicaid |
$4,274.41
|
|
|
APR-DRG 42.00: CONNECTIVE TISSUE DISORDERS
|
Facility
|
IP
|
$16,448.38
|
|
|
Service Code
|
APR-DRG 3464
|
| Min. Negotiated Rate |
$15,665.12 |
| Max. Negotiated Rate |
$16,448.38 |
| Rate for Payer: BCBS Complete |
$16,448.38
|
| Rate for Payer: Mclaren Medicaid |
$15,665.12
|
| Rate for Payer: Meridian Medicaid |
$16,448.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,665.12
|
| Rate for Payer: UHCCP Medicaid |
$16,448.38
|
|
|
APR-DRG 42.00: CONNECTIVE TISSUE DISORDERS
|
Facility
|
IP
|
$6,005.82
|
|
|
Service Code
|
APR-DRG 3462
|
| Min. Negotiated Rate |
$5,719.83 |
| Max. Negotiated Rate |
$6,005.82 |
| Rate for Payer: BCBS Complete |
$6,005.82
|
| Rate for Payer: Mclaren Medicaid |
$5,719.83
|
| Rate for Payer: Meridian Medicaid |
$6,005.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,719.83
|
| Rate for Payer: UHCCP Medicaid |
$6,005.82
|
|
|
APR-DRG 42.00: CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE
|
Facility
|
IP
|
$6,709.21
|
|
|
Service Code
|
APR-DRG 3843
|
| Min. Negotiated Rate |
$6,389.72 |
| Max. Negotiated Rate |
$6,709.21 |
| Rate for Payer: BCBS Complete |
$6,709.21
|
| Rate for Payer: Mclaren Medicaid |
$6,389.72
|
| Rate for Payer: Meridian Medicaid |
$6,709.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,389.72
|
| Rate for Payer: UHCCP Medicaid |
$6,709.21
|
|
|
APR-DRG 42.00: CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE
|
Facility
|
IP
|
$10,767.19
|
|
|
Service Code
|
APR-DRG 3844
|
| Min. Negotiated Rate |
$10,254.47 |
| Max. Negotiated Rate |
$10,767.19 |
| Rate for Payer: BCBS Complete |
$10,767.19
|
| Rate for Payer: Mclaren Medicaid |
$10,254.47
|
| Rate for Payer: Meridian Medicaid |
$10,767.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,254.47
|
| Rate for Payer: UHCCP Medicaid |
$10,767.19
|
|
|
APR-DRG 42.00: CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE
|
Facility
|
IP
|
$3,841.56
|
|
|
Service Code
|
APR-DRG 3841
|
| Min. Negotiated Rate |
$3,658.63 |
| Max. Negotiated Rate |
$3,841.56 |
| Rate for Payer: BCBS Complete |
$3,841.56
|
| Rate for Payer: Mclaren Medicaid |
$3,658.63
|
| Rate for Payer: Meridian Medicaid |
$3,841.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,658.63
|
| Rate for Payer: UHCCP Medicaid |
$3,841.56
|
|
|
APR-DRG 42.00: CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE
|
Facility
|
IP
|
$4,707.27
|
|
|
Service Code
|
APR-DRG 3842
|
| Min. Negotiated Rate |
$4,483.11 |
| Max. Negotiated Rate |
$4,707.27 |
| Rate for Payer: BCBS Complete |
$4,707.27
|
| Rate for Payer: Mclaren Medicaid |
$4,483.11
|
| Rate for Payer: Meridian Medicaid |
$4,707.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,483.11
|
| Rate for Payer: UHCCP Medicaid |
$4,707.27
|
|
|
APR-DRG 42.00: CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$28,784.66
|
|
|
Service Code
|
APR-DRG 1653
|
| Min. Negotiated Rate |
$27,413.96 |
| Max. Negotiated Rate |
$28,784.66 |
| Rate for Payer: BCBS Complete |
$28,784.66
|
| Rate for Payer: Mclaren Medicaid |
$27,413.96
|
| Rate for Payer: Meridian Medicaid |
$28,784.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$27,413.96
|
| Rate for Payer: UHCCP Medicaid |
$28,784.66
|
|
|
APR-DRG 42.00: CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$20,776.90
|
|
|
Service Code
|
APR-DRG 1651
|
| Min. Negotiated Rate |
$19,787.52 |
| Max. Negotiated Rate |
$20,776.90 |
| Rate for Payer: BCBS Complete |
$20,776.90
|
| Rate for Payer: Mclaren Medicaid |
$19,787.52
|
| Rate for Payer: Meridian Medicaid |
$20,776.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,787.52
|
| Rate for Payer: UHCCP Medicaid |
$20,776.90
|
|
|
APR-DRG 42.00: CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$38,740.25
|
|
|
Service Code
|
APR-DRG 1654
|
| Min. Negotiated Rate |
$36,895.48 |
| Max. Negotiated Rate |
$38,740.25 |
| Rate for Payer: BCBS Complete |
$38,740.25
|
| Rate for Payer: Mclaren Medicaid |
$36,895.48
|
| Rate for Payer: Meridian Medicaid |
$38,740.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$36,895.48
|
| Rate for Payer: UHCCP Medicaid |
$38,740.25
|
|