|
APR-DRG 42.00: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$17,584.61
|
|
|
Service Code
|
APR-DRG 9503
|
| Min. Negotiated Rate |
$16,747.25 |
| Max. Negotiated Rate |
$17,584.61 |
| Rate for Payer: BCBS Complete |
$17,584.61
|
| Rate for Payer: Mclaren Medicaid |
$16,747.25
|
| Rate for Payer: Meridian Medicaid |
$17,584.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,747.25
|
| Rate for Payer: UHCCP Medicaid |
$17,584.61
|
|
|
APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$3,354.60
|
|
|
Service Code
|
APR-DRG 8431
|
| Min. Negotiated Rate |
$3,194.86 |
| Max. Negotiated Rate |
$3,354.60 |
| Rate for Payer: BCBS Complete |
$3,354.60
|
| Rate for Payer: Mclaren Medicaid |
$3,194.86
|
| Rate for Payer: Meridian Medicaid |
$3,354.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,194.86
|
| Rate for Payer: UHCCP Medicaid |
$3,354.60
|
|
|
APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$5,410.65
|
|
|
Service Code
|
APR-DRG 8432
|
| Min. Negotiated Rate |
$5,153.00 |
| Max. Negotiated Rate |
$5,410.65 |
| Rate for Payer: BCBS Complete |
$5,410.65
|
| Rate for Payer: Mclaren Medicaid |
$5,153.00
|
| Rate for Payer: Meridian Medicaid |
$5,410.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,153.00
|
| Rate for Payer: UHCCP Medicaid |
$5,410.65
|
|
|
APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$23,806.86
|
|
|
Service Code
|
APR-DRG 8434
|
| Min. Negotiated Rate |
$22,673.20 |
| Max. Negotiated Rate |
$23,806.86 |
| Rate for Payer: BCBS Complete |
$23,806.86
|
| Rate for Payer: Mclaren Medicaid |
$22,673.20
|
| Rate for Payer: Meridian Medicaid |
$23,806.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,673.20
|
| Rate for Payer: UHCCP Medicaid |
$23,806.86
|
|
|
APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$16,556.59
|
|
|
Service Code
|
APR-DRG 8433
|
| Min. Negotiated Rate |
$15,768.18 |
| Max. Negotiated Rate |
$16,556.59 |
| Rate for Payer: BCBS Complete |
$16,556.59
|
| Rate for Payer: Mclaren Medicaid |
$15,768.18
|
| Rate for Payer: Meridian Medicaid |
$16,556.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,768.18
|
| Rate for Payer: UHCCP Medicaid |
$16,556.59
|
|
|
APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT
|
Facility
|
IP
|
$26,728.61
|
|
|
Service Code
|
APR-DRG 8412
|
| Min. Negotiated Rate |
$25,455.82 |
| Max. Negotiated Rate |
$26,728.61 |
| Rate for Payer: BCBS Complete |
$26,728.61
|
| Rate for Payer: Mclaren Medicaid |
$25,455.82
|
| Rate for Payer: Meridian Medicaid |
$26,728.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,455.82
|
| Rate for Payer: UHCCP Medicaid |
$26,728.61
|
|
|
APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT
|
Facility
|
IP
|
$38,902.57
|
|
|
Service Code
|
APR-DRG 8413
|
| Min. Negotiated Rate |
$37,050.07 |
| Max. Negotiated Rate |
$38,902.57 |
| Rate for Payer: BCBS Complete |
$38,902.57
|
| Rate for Payer: Mclaren Medicaid |
$37,050.07
|
| Rate for Payer: Meridian Medicaid |
$38,902.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$37,050.07
|
| Rate for Payer: UHCCP Medicaid |
$38,902.57
|
|
|
APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT
|
Facility
|
IP
|
$123,795.67
|
|
|
Service Code
|
APR-DRG 8414
|
| Min. Negotiated Rate |
$117,900.64 |
| Max. Negotiated Rate |
$123,795.67 |
| Rate for Payer: BCBS Complete |
$123,795.67
|
| Rate for Payer: Mclaren Medicaid |
$117,900.64
|
| Rate for Payer: Meridian Medicaid |
$123,795.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$117,900.64
|
| Rate for Payer: UHCCP Medicaid |
$123,795.67
|
|
|
APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT
|
Facility
|
IP
|
$26,349.87
|
|
|
Service Code
|
APR-DRG 8411
|
| Min. Negotiated Rate |
$25,095.11 |
| Max. Negotiated Rate |
$26,349.87 |
| Rate for Payer: BCBS Complete |
$26,349.87
|
| Rate for Payer: Mclaren Medicaid |
$25,095.11
|
| Rate for Payer: Meridian Medicaid |
$26,349.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,095.11
|
| Rate for Payer: UHCCP Medicaid |
$26,349.87
|
|
|
APR-DRG 42.00: EXTERNAL HEART ASSIST DEVICES
|
Facility
|
IP
|
$36,413.67
|
|
|
Service Code
|
APR-DRG 1784
|
| Min. Negotiated Rate |
$34,679.69 |
| Max. Negotiated Rate |
$36,413.67 |
| Rate for Payer: BCBS Complete |
$36,413.67
|
| Rate for Payer: Mclaren Medicaid |
$34,679.69
|
| Rate for Payer: Meridian Medicaid |
$36,413.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$34,679.69
|
| Rate for Payer: UHCCP Medicaid |
$36,413.67
|
|
|
APR-DRG 42.00: EXTERNAL HEART ASSIST DEVICES
|
Facility
|
IP
|
$21,534.39
|
|
|
Service Code
|
APR-DRG 1781
|
| Min. Negotiated Rate |
$20,508.94 |
| Max. Negotiated Rate |
$21,534.39 |
| Rate for Payer: BCBS Complete |
$21,534.39
|
| Rate for Payer: Mclaren Medicaid |
$20,508.94
|
| Rate for Payer: Meridian Medicaid |
$21,534.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$20,508.94
|
| Rate for Payer: UHCCP Medicaid |
$21,534.39
|
|
|
APR-DRG 42.00: EXTERNAL HEART ASSIST DEVICES
|
Facility
|
IP
|
$23,915.07
|
|
|
Service Code
|
APR-DRG 1782
|
| Min. Negotiated Rate |
$22,776.26 |
| Max. Negotiated Rate |
$23,915.07 |
| Rate for Payer: BCBS Complete |
$23,915.07
|
| Rate for Payer: Mclaren Medicaid |
$22,776.26
|
| Rate for Payer: Meridian Medicaid |
$23,915.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,776.26
|
| Rate for Payer: UHCCP Medicaid |
$23,915.07
|
|
|
APR-DRG 42.00: EXTERNAL HEART ASSIST DEVICES
|
Facility
|
IP
|
$29,379.83
|
|
|
Service Code
|
APR-DRG 1783
|
| Min. Negotiated Rate |
$27,980.79 |
| Max. Negotiated Rate |
$29,379.83 |
| Rate for Payer: BCBS Complete |
$29,379.83
|
| Rate for Payer: Mclaren Medicaid |
$27,980.79
|
| Rate for Payer: Meridian Medicaid |
$29,379.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$27,980.79
|
| Rate for Payer: UHCCP Medicaid |
$29,379.83
|
|
|
APR-DRG 42.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
|
Facility
|
IP
|
$113,082.58
|
|
|
Service Code
|
APR-DRG 0094
|
| Min. Negotiated Rate |
$107,697.70 |
| Max. Negotiated Rate |
$113,082.58 |
| Rate for Payer: BCBS Complete |
$113,082.58
|
| Rate for Payer: Mclaren Medicaid |
$107,697.70
|
| Rate for Payer: Meridian Medicaid |
$113,082.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$107,697.70
|
| Rate for Payer: UHCCP Medicaid |
$113,082.58
|
|
|
APR-DRG 42.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
|
Facility
|
IP
|
$49,074.60
|
|
|
Service Code
|
APR-DRG 0092
|
| Min. Negotiated Rate |
$46,737.71 |
| Max. Negotiated Rate |
$49,074.60 |
| Rate for Payer: BCBS Complete |
$49,074.60
|
| Rate for Payer: Mclaren Medicaid |
$46,737.71
|
| Rate for Payer: Meridian Medicaid |
$49,074.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$46,737.71
|
| Rate for Payer: UHCCP Medicaid |
$49,074.60
|
|
|
APR-DRG 42.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
|
Facility
|
IP
|
$81,376.18
|
|
|
Service Code
|
APR-DRG 0093
|
| Min. Negotiated Rate |
$77,501.12 |
| Max. Negotiated Rate |
$81,376.18 |
| Rate for Payer: BCBS Complete |
$81,376.18
|
| Rate for Payer: Mclaren Medicaid |
$77,501.12
|
| Rate for Payer: Meridian Medicaid |
$81,376.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$77,501.12
|
| Rate for Payer: UHCCP Medicaid |
$81,376.18
|
|
|
APR-DRG 42.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
|
Facility
|
IP
|
$35,115.12
|
|
|
Service Code
|
APR-DRG 0091
|
| Min. Negotiated Rate |
$33,442.97 |
| Max. Negotiated Rate |
$35,115.12 |
| Rate for Payer: BCBS Complete |
$35,115.12
|
| Rate for Payer: Mclaren Medicaid |
$33,442.97
|
| Rate for Payer: Meridian Medicaid |
$35,115.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$33,442.97
|
| Rate for Payer: UHCCP Medicaid |
$35,115.12
|
|
|
APR-DRG 42.00: EYE INFECTIONS AND OTHER EYE DISORDERS
|
Facility
|
IP
|
$3,192.28
|
|
|
Service Code
|
APR-DRG 0821
|
| Min. Negotiated Rate |
$3,040.27 |
| Max. Negotiated Rate |
$3,192.28 |
| Rate for Payer: BCBS Complete |
$3,192.28
|
| Rate for Payer: Mclaren Medicaid |
$3,040.27
|
| Rate for Payer: Meridian Medicaid |
$3,192.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,040.27
|
| Rate for Payer: UHCCP Medicaid |
$3,192.28
|
|
|
APR-DRG 42.00: EYE INFECTIONS AND OTHER EYE DISORDERS
|
Facility
|
IP
|
$5,140.12
|
|
|
Service Code
|
APR-DRG 0822
|
| 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: EYE INFECTIONS AND OTHER EYE DISORDERS
|
Facility
|
IP
|
$9,576.85
|
|
|
Service Code
|
APR-DRG 0823
|
| Min. Negotiated Rate |
$9,120.81 |
| Max. Negotiated Rate |
$9,576.85 |
| Rate for Payer: BCBS Complete |
$9,576.85
|
| Rate for Payer: Mclaren Medicaid |
$9,120.81
|
| Rate for Payer: Meridian Medicaid |
$9,576.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,120.81
|
| Rate for Payer: UHCCP Medicaid |
$9,576.85
|
|
|
APR-DRG 42.00: EYE INFECTIONS AND OTHER EYE DISORDERS
|
Facility
|
IP
|
$13,743.05
|
|
|
Service Code
|
APR-DRG 0824
|
| Min. Negotiated Rate |
$13,088.62 |
| Max. Negotiated Rate |
$13,743.05 |
| Rate for Payer: BCBS Complete |
$13,743.05
|
| Rate for Payer: Mclaren Medicaid |
$13,088.62
|
| Rate for Payer: Meridian Medicaid |
$13,743.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,088.62
|
| Rate for Payer: UHCCP Medicaid |
$13,743.05
|
|
|
APR-DRG 42.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$32,193.37
|
|
|
Service Code
|
APR-DRG 0924
|
| Min. Negotiated Rate |
$30,660.35 |
| Max. Negotiated Rate |
$32,193.37 |
| Rate for Payer: BCBS Complete |
$32,193.37
|
| Rate for Payer: Mclaren Medicaid |
$30,660.35
|
| Rate for Payer: Meridian Medicaid |
$32,193.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$30,660.35
|
| Rate for Payer: UHCCP Medicaid |
$32,193.37
|
|
|
APR-DRG 42.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$11,849.32
|
|
|
Service Code
|
APR-DRG 0922
|
| Min. Negotiated Rate |
$11,285.07 |
| Max. Negotiated Rate |
$11,849.32 |
| Rate for Payer: BCBS Complete |
$11,849.32
|
| Rate for Payer: Mclaren Medicaid |
$11,285.07
|
| Rate for Payer: Meridian Medicaid |
$11,849.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,285.07
|
| Rate for Payer: UHCCP Medicaid |
$11,849.32
|
|
|
APR-DRG 42.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$10,550.77
|
|
|
Service Code
|
APR-DRG 0921
|
| Min. Negotiated Rate |
$10,048.35 |
| Max. Negotiated Rate |
$10,550.77 |
| Rate for Payer: BCBS Complete |
$10,550.77
|
| Rate for Payer: Mclaren Medicaid |
$10,048.35
|
| Rate for Payer: Meridian Medicaid |
$10,550.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,048.35
|
| Rate for Payer: UHCCP Medicaid |
$10,550.77
|
|
|
APR-DRG 42.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$18,450.32
|
|
|
Service Code
|
APR-DRG 0923
|
| Min. Negotiated Rate |
$17,571.73 |
| Max. Negotiated Rate |
$18,450.32 |
| Rate for Payer: BCBS Complete |
$18,450.32
|
| Rate for Payer: Mclaren Medicaid |
$17,571.73
|
| Rate for Payer: Meridian Medicaid |
$18,450.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,571.73
|
| Rate for Payer: UHCCP Medicaid |
$18,450.32
|
|