|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$13,526.62
|
|
|
Service Code
|
APR-DRG 6112
|
| Min. Negotiated Rate |
$12,882.50 |
| Max. Negotiated Rate |
$13,526.62 |
| Rate for Payer: BCBS Complete |
$13,526.62
|
| Rate for Payer: Mclaren Medicaid |
$12,882.50
|
| Rate for Payer: Meridian Medicaid |
$13,526.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,882.50
|
| Rate for Payer: UHCCP Medicaid |
$13,526.62
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$4,815.48
|
|
|
Service Code
|
APR-DRG 6111
|
| Min. Negotiated Rate |
$4,586.17 |
| Max. Negotiated Rate |
$4,815.48 |
| Rate for Payer: BCBS Complete |
$4,815.48
|
| Rate for Payer: Mclaren Medicaid |
$4,586.17
|
| Rate for Payer: Meridian Medicaid |
$4,815.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,586.17
|
| Rate for Payer: UHCCP Medicaid |
$4,815.48
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$4,112.09
|
|
|
Service Code
|
APR-DRG 6141
|
| Min. Negotiated Rate |
$3,916.28 |
| Max. Negotiated Rate |
$4,112.09 |
| Rate for Payer: BCBS Complete |
$4,112.09
|
| Rate for Payer: Mclaren Medicaid |
$3,916.28
|
| Rate for Payer: Meridian Medicaid |
$4,112.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,916.28
|
| Rate for Payer: UHCCP Medicaid |
$4,112.09
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$27,269.68
|
|
|
Service Code
|
APR-DRG 6144
|
| Min. Negotiated Rate |
$25,971.12 |
| Max. Negotiated Rate |
$27,269.68 |
| Rate for Payer: BCBS Complete |
$27,269.68
|
| Rate for Payer: Mclaren Medicaid |
$25,971.12
|
| Rate for Payer: Meridian Medicaid |
$27,269.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,971.12
|
| Rate for Payer: UHCCP Medicaid |
$27,269.68
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$10,550.77
|
|
|
Service Code
|
APR-DRG 6142
|
| 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: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$20,181.72
|
|
|
Service Code
|
APR-DRG 6143
|
| Min. Negotiated Rate |
$19,220.69 |
| Max. Negotiated Rate |
$20,181.72 |
| Rate for Payer: BCBS Complete |
$20,181.72
|
| Rate for Payer: Mclaren Medicaid |
$19,220.69
|
| Rate for Payer: Meridian Medicaid |
$20,181.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,220.69
|
| Rate for Payer: UHCCP Medicaid |
$20,181.72
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$30,461.96
|
|
|
Service Code
|
APR-DRG 6123
|
| Min. Negotiated Rate |
$29,011.39 |
| Max. Negotiated Rate |
$30,461.96 |
| Rate for Payer: BCBS Complete |
$30,461.96
|
| Rate for Payer: Mclaren Medicaid |
$29,011.39
|
| Rate for Payer: Meridian Medicaid |
$30,461.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$29,011.39
|
| Rate for Payer: UHCCP Medicaid |
$30,461.96
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$43,718.05
|
|
|
Service Code
|
APR-DRG 6124
|
| Min. Negotiated Rate |
$41,636.24 |
| Max. Negotiated Rate |
$43,718.05 |
| Rate for Payer: BCBS Complete |
$43,718.05
|
| Rate for Payer: Mclaren Medicaid |
$41,636.24
|
| Rate for Payer: Meridian Medicaid |
$43,718.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$41,636.24
|
| Rate for Payer: UHCCP Medicaid |
$43,718.05
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$15,961.42
|
|
|
Service Code
|
APR-DRG 6122
|
| Min. Negotiated Rate |
$15,201.35 |
| Max. Negotiated Rate |
$15,961.42 |
| Rate for Payer: BCBS Complete |
$15,961.42
|
| Rate for Payer: Mclaren Medicaid |
$15,201.35
|
| Rate for Payer: Meridian Medicaid |
$15,961.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,201.35
|
| Rate for Payer: UHCCP Medicaid |
$15,961.42
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$10,334.34
|
|
|
Service Code
|
APR-DRG 6121
|
| Min. Negotiated Rate |
$9,842.23 |
| Max. Negotiated Rate |
$10,334.34 |
| Rate for Payer: BCBS Complete |
$10,334.34
|
| Rate for Payer: Mclaren Medicaid |
$9,842.23
|
| Rate for Payer: Meridian Medicaid |
$10,334.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,842.23
|
| Rate for Payer: UHCCP Medicaid |
$10,334.34
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$140,027.62
|
|
|
Service Code
|
APR-DRG 6094
|
| Min. Negotiated Rate |
$133,359.64 |
| Max. Negotiated Rate |
$140,027.62 |
| Rate for Payer: BCBS Complete |
$140,027.62
|
| Rate for Payer: Mclaren Medicaid |
$133,359.64
|
| Rate for Payer: Meridian Medicaid |
$140,027.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$133,359.64
|
| Rate for Payer: UHCCP Medicaid |
$140,027.62
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$30,407.85
|
|
|
Service Code
|
APR-DRG 6092
|
| Min. Negotiated Rate |
$28,959.86 |
| Max. Negotiated Rate |
$30,407.85 |
| Rate for Payer: BCBS Complete |
$30,407.85
|
| Rate for Payer: Mclaren Medicaid |
$28,959.86
|
| Rate for Payer: Meridian Medicaid |
$30,407.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$28,959.86
|
| Rate for Payer: UHCCP Medicaid |
$30,407.85
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$25,213.63
|
|
|
Service Code
|
APR-DRG 6091
|
| Min. Negotiated Rate |
$24,012.98 |
| Max. Negotiated Rate |
$25,213.63 |
| Rate for Payer: BCBS Complete |
$25,213.63
|
| Rate for Payer: Mclaren Medicaid |
$24,012.98
|
| Rate for Payer: Meridian Medicaid |
$25,213.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$24,012.98
|
| Rate for Payer: UHCCP Medicaid |
$25,213.63
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$47,884.25
|
|
|
Service Code
|
APR-DRG 6093
|
| Min. Negotiated Rate |
$45,604.05 |
| Max. Negotiated Rate |
$47,884.25 |
| Rate for Payer: BCBS Complete |
$47,884.25
|
| Rate for Payer: Mclaren Medicaid |
$45,604.05
|
| Rate for Payer: Meridian Medicaid |
$47,884.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$45,604.05
|
| Rate for Payer: UHCCP Medicaid |
$47,884.25
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$200,897.43
|
|
|
Service Code
|
APR-DRG 5884
|
| Min. Negotiated Rate |
$191,330.89 |
| Max. Negotiated Rate |
$200,897.43 |
| Rate for Payer: BCBS Complete |
$200,897.43
|
| Rate for Payer: Mclaren Medicaid |
$191,330.89
|
| Rate for Payer: Meridian Medicaid |
$200,897.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$191,330.89
|
| Rate for Payer: UHCCP Medicaid |
$200,897.43
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$111,513.50
|
|
|
Service Code
|
APR-DRG 5882
|
| Min. Negotiated Rate |
$106,203.33 |
| Max. Negotiated Rate |
$111,513.50 |
| Rate for Payer: BCBS Complete |
$111,513.50
|
| Rate for Payer: Mclaren Medicaid |
$106,203.33
|
| Rate for Payer: Meridian Medicaid |
$111,513.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$106,203.33
|
| Rate for Payer: UHCCP Medicaid |
$111,513.50
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$132,669.14
|
|
|
Service Code
|
APR-DRG 5883
|
| Min. Negotiated Rate |
$126,351.56 |
| Max. Negotiated Rate |
$132,669.14 |
| Rate for Payer: BCBS Complete |
$132,669.14
|
| Rate for Payer: Mclaren Medicaid |
$126,351.56
|
| Rate for Payer: Meridian Medicaid |
$132,669.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$126,351.56
|
| Rate for Payer: UHCCP Medicaid |
$132,669.14
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$95,606.19
|
|
|
Service Code
|
APR-DRG 5881
|
| Min. Negotiated Rate |
$91,053.51 |
| Max. Negotiated Rate |
$95,606.19 |
| Rate for Payer: BCBS Complete |
$95,606.19
|
| Rate for Payer: Mclaren Medicaid |
$91,053.51
|
| Rate for Payer: Meridian Medicaid |
$95,606.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$91,053.51
|
| Rate for Payer: UHCCP Medicaid |
$95,606.19
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$919.81
|
|
|
Service Code
|
APR-DRG 6261
|
| Min. Negotiated Rate |
$876.01 |
| Max. Negotiated Rate |
$919.81 |
| Rate for Payer: BCBS Complete |
$919.81
|
| Rate for Payer: Mclaren Medicaid |
$876.01
|
| Rate for Payer: Meridian Medicaid |
$919.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.01
|
| Rate for Payer: UHCCP Medicaid |
$919.81
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$3,462.82
|
|
|
Service Code
|
APR-DRG 6263
|
| Min. Negotiated Rate |
$3,297.92 |
| Max. Negotiated Rate |
$3,462.82 |
| Rate for Payer: BCBS Complete |
$3,462.82
|
| Rate for Payer: Mclaren Medicaid |
$3,297.92
|
| Rate for Payer: Meridian Medicaid |
$3,462.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,297.92
|
| Rate for Payer: UHCCP Medicaid |
$3,462.82
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,460.88
|
|
|
Service Code
|
APR-DRG 6262
|
| Min. Negotiated Rate |
$1,391.31 |
| Max. Negotiated Rate |
$1,460.88 |
| Rate for Payer: BCBS Complete |
$1,460.88
|
| Rate for Payer: Mclaren Medicaid |
$1,391.31
|
| Rate for Payer: Meridian Medicaid |
$1,460.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,391.31
|
| Rate for Payer: UHCCP Medicaid |
$1,460.88
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$6,600.99
|
|
|
Service Code
|
APR-DRG 6264
|
| Min. Negotiated Rate |
$6,286.66 |
| Max. Negotiated Rate |
$6,600.99 |
| Rate for Payer: BCBS Complete |
$6,600.99
|
| Rate for Payer: Mclaren Medicaid |
$6,286.66
|
| Rate for Payer: Meridian Medicaid |
$6,600.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,286.66
|
| Rate for Payer: UHCCP Medicaid |
$6,600.99
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$29,433.94
|
|
|
Service Code
|
APR-DRG 6234
|
| Min. Negotiated Rate |
$28,032.32 |
| Max. Negotiated Rate |
$29,433.94 |
| Rate for Payer: BCBS Complete |
$29,433.94
|
| Rate for Payer: Mclaren Medicaid |
$28,032.32
|
| Rate for Payer: Meridian Medicaid |
$29,433.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$28,032.32
|
| Rate for Payer: UHCCP Medicaid |
$29,433.94
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$3,625.14
|
|
|
Service Code
|
APR-DRG 6231
|
| Min. Negotiated Rate |
$3,452.51 |
| Max. Negotiated Rate |
$3,625.14 |
| Rate for Payer: BCBS Complete |
$3,625.14
|
| Rate for Payer: Mclaren Medicaid |
$3,452.51
|
| Rate for Payer: Meridian Medicaid |
$3,625.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,452.51
|
| Rate for Payer: UHCCP Medicaid |
$3,625.14
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$6,492.78
|
|
|
Service Code
|
APR-DRG 6232
|
| Min. Negotiated Rate |
$6,183.60 |
| Max. Negotiated Rate |
$6,492.78 |
| Rate for Payer: BCBS Complete |
$6,492.78
|
| Rate for Payer: Mclaren Medicaid |
$6,183.60
|
| Rate for Payer: Meridian Medicaid |
$6,492.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,183.60
|
| Rate for Payer: UHCCP Medicaid |
$6,492.78
|
|