|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY
|
Facility
|
IP
|
$42,148.96
|
|
|
Service Code
|
APR-DRG 6073
|
| Min. Negotiated Rate |
$40,141.87 |
| Max. Negotiated Rate |
$42,148.96 |
| Rate for Payer: BCBS Complete |
$42,148.96
|
| Rate for Payer: Mclaren Medicaid |
$40,141.87
|
| Rate for Payer: Meridian Medicaid |
$42,148.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$40,141.87
|
| Rate for Payer: UHCCP Medicaid |
$42,148.96
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY
|
Facility
|
IP
|
$61,464.98
|
|
|
Service Code
|
APR-DRG 6074
|
| Min. Negotiated Rate |
$58,538.08 |
| Max. Negotiated Rate |
$61,464.98 |
| Rate for Payer: BCBS Complete |
$61,464.98
|
| Rate for Payer: Mclaren Medicaid |
$58,538.08
|
| Rate for Payer: Meridian Medicaid |
$61,464.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$58,538.08
|
| Rate for Payer: UHCCP Medicaid |
$61,464.98
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$10,334.34
|
|
|
Service Code
|
APR-DRG 6131
|
| 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 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$50,643.68
|
|
|
Service Code
|
APR-DRG 6134
|
| Min. Negotiated Rate |
$48,232.08 |
| Max. Negotiated Rate |
$50,643.68 |
| Rate for Payer: BCBS Complete |
$50,643.68
|
| Rate for Payer: Mclaren Medicaid |
$48,232.08
|
| Rate for Payer: Meridian Medicaid |
$50,643.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$48,232.08
|
| Rate for Payer: UHCCP Medicaid |
$50,643.68
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$27,377.89
|
|
|
Service Code
|
APR-DRG 6133
|
| Min. Negotiated Rate |
$26,074.18 |
| Max. Negotiated Rate |
$27,377.89 |
| Rate for Payer: BCBS Complete |
$27,377.89
|
| Rate for Payer: Mclaren Medicaid |
$26,074.18
|
| Rate for Payer: Meridian Medicaid |
$27,377.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,074.18
|
| Rate for Payer: UHCCP Medicaid |
$27,377.89
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$16,123.74
|
|
|
Service Code
|
APR-DRG 6132
|
| Min. Negotiated Rate |
$15,355.94 |
| Max. Negotiated Rate |
$16,123.74 |
| Rate for Payer: BCBS Complete |
$16,123.74
|
| Rate for Payer: Mclaren Medicaid |
$15,355.94
|
| Rate for Payer: Meridian Medicaid |
$16,123.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,355.94
|
| Rate for Payer: UHCCP Medicaid |
$16,123.74
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$16,773.01
|
|
|
Service Code
|
APR-DRG 6112
|
| Min. Negotiated Rate |
$15,974.30 |
| Max. Negotiated Rate |
$16,773.01 |
| Rate for Payer: BCBS Complete |
$16,773.01
|
| Rate for Payer: Mclaren Medicaid |
$15,974.30
|
| Rate for Payer: Meridian Medicaid |
$16,773.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,974.30
|
| Rate for Payer: UHCCP Medicaid |
$16,773.01
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$27,269.68
|
|
|
Service Code
|
APR-DRG 6113
|
| 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 MAJOR ANOMALY
|
Facility
|
IP
|
$51,130.64
|
|
|
Service Code
|
APR-DRG 6114
|
| Min. Negotiated Rate |
$48,695.85 |
| Max. Negotiated Rate |
$51,130.64 |
| Rate for Payer: BCBS Complete |
$51,130.64
|
| Rate for Payer: Mclaren Medicaid |
$48,695.85
|
| Rate for Payer: Meridian Medicaid |
$51,130.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$48,695.85
|
| Rate for Payer: UHCCP Medicaid |
$51,130.64
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$8,765.25
|
|
|
Service Code
|
APR-DRG 6111
|
| Min. Negotiated Rate |
$8,347.86 |
| Max. Negotiated Rate |
$8,765.25 |
| Rate for Payer: BCBS Complete |
$8,765.25
|
| Rate for Payer: Mclaren Medicaid |
$8,347.86
|
| Rate for Payer: Meridian Medicaid |
$8,765.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,347.86
|
| Rate for Payer: UHCCP Medicaid |
$8,765.25
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$33,816.56
|
|
|
Service Code
|
APR-DRG 6144
|
| Min. Negotiated Rate |
$32,206.25 |
| Max. Negotiated Rate |
$33,816.56 |
| Rate for Payer: BCBS Complete |
$33,816.56
|
| Rate for Payer: Mclaren Medicaid |
$32,206.25
|
| Rate for Payer: Meridian Medicaid |
$33,816.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$32,206.25
|
| Rate for Payer: UHCCP Medicaid |
$33,816.56
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$6,817.42
|
|
|
Service Code
|
APR-DRG 6141
|
| Min. Negotiated Rate |
$6,492.78 |
| Max. Negotiated Rate |
$6,817.42 |
| Rate for Payer: BCBS Complete |
$6,817.42
|
| Rate for Payer: Mclaren Medicaid |
$6,492.78
|
| Rate for Payer: Meridian Medicaid |
$6,817.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,492.78
|
| Rate for Payer: UHCCP Medicaid |
$6,817.42
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$22,832.94
|
|
|
Service Code
|
APR-DRG 6143
|
| Min. Negotiated Rate |
$21,745.66 |
| Max. Negotiated Rate |
$22,832.94 |
| Rate for Payer: BCBS Complete |
$22,832.94
|
| Rate for Payer: Mclaren Medicaid |
$21,745.66
|
| Rate for Payer: Meridian Medicaid |
$22,832.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,745.66
|
| Rate for Payer: UHCCP Medicaid |
$22,832.94
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$13,201.99
|
|
|
Service Code
|
APR-DRG 6142
|
| Min. Negotiated Rate |
$12,573.32 |
| Max. Negotiated Rate |
$13,201.99 |
| Rate for Payer: BCBS Complete |
$13,201.99
|
| Rate for Payer: Mclaren Medicaid |
$12,573.32
|
| Rate for Payer: Meridian Medicaid |
$13,201.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,573.32
|
| Rate for Payer: UHCCP Medicaid |
$13,201.99
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$40,255.24
|
|
|
Service Code
|
APR-DRG 6124
|
| Min. Negotiated Rate |
$38,338.32 |
| Max. Negotiated Rate |
$40,255.24 |
| Rate for Payer: BCBS Complete |
$40,255.24
|
| Rate for Payer: Mclaren Medicaid |
$38,338.32
|
| Rate for Payer: Meridian Medicaid |
$40,255.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$38,338.32
|
| Rate for Payer: UHCCP Medicaid |
$40,255.24
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$13,472.52
|
|
|
Service Code
|
APR-DRG 6121
|
| Min. Negotiated Rate |
$12,830.97 |
| Max. Negotiated Rate |
$13,472.52 |
| Rate for Payer: BCBS Complete |
$13,472.52
|
| Rate for Payer: Mclaren Medicaid |
$12,830.97
|
| Rate for Payer: Meridian Medicaid |
$13,472.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,830.97
|
| Rate for Payer: UHCCP Medicaid |
$13,472.52
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$27,918.95
|
|
|
Service Code
|
APR-DRG 6123
|
| Min. Negotiated Rate |
$26,589.48 |
| Max. Negotiated Rate |
$27,918.95 |
| Rate for Payer: BCBS Complete |
$27,918.95
|
| Rate for Payer: Mclaren Medicaid |
$26,589.48
|
| Rate for Payer: Meridian Medicaid |
$27,918.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,589.48
|
| Rate for Payer: UHCCP Medicaid |
$27,918.95
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$19,532.45
|
|
|
Service Code
|
APR-DRG 6122
|
| Min. Negotiated Rate |
$18,602.33 |
| Max. Negotiated Rate |
$19,532.45 |
| Rate for Payer: BCBS Complete |
$19,532.45
|
| Rate for Payer: Mclaren Medicaid |
$18,602.33
|
| Rate for Payer: Meridian Medicaid |
$19,532.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,602.33
|
| Rate for Payer: UHCCP Medicaid |
$19,532.45
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$23,211.69
|
|
|
Service Code
|
APR-DRG 6091
|
| Min. Negotiated Rate |
$22,106.37 |
| Max. Negotiated Rate |
$23,211.69 |
| Rate for Payer: BCBS Complete |
$23,211.69
|
| Rate for Payer: Mclaren Medicaid |
$22,106.37
|
| Rate for Payer: Meridian Medicaid |
$23,211.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,106.37
|
| Rate for Payer: UHCCP Medicaid |
$23,211.69
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$127,583.13
|
|
|
Service Code
|
APR-DRG 6094
|
| Min. Negotiated Rate |
$121,507.74 |
| Max. Negotiated Rate |
$127,583.13 |
| Rate for Payer: BCBS Complete |
$127,583.13
|
| Rate for Payer: Mclaren Medicaid |
$121,507.74
|
| Rate for Payer: Meridian Medicaid |
$127,583.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$121,507.74
|
| Rate for Payer: UHCCP Medicaid |
$127,583.13
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$44,259.12
|
|
|
Service Code
|
APR-DRG 6093
|
| Min. Negotiated Rate |
$42,151.54 |
| Max. Negotiated Rate |
$44,259.12 |
| Rate for Payer: BCBS Complete |
$44,259.12
|
| Rate for Payer: Mclaren Medicaid |
$42,151.54
|
| Rate for Payer: Meridian Medicaid |
$44,259.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$42,151.54
|
| Rate for Payer: UHCCP Medicaid |
$44,259.12
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$28,892.87
|
|
|
Service Code
|
APR-DRG 6092
|
| Min. Negotiated Rate |
$27,517.02 |
| Max. Negotiated Rate |
$28,892.87 |
| Rate for Payer: BCBS Complete |
$28,892.87
|
| Rate for Payer: Mclaren Medicaid |
$27,517.02
|
| Rate for Payer: Meridian Medicaid |
$28,892.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$27,517.02
|
| Rate for Payer: UHCCP Medicaid |
$28,892.87
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$121,956.05
|
|
|
Service Code
|
APR-DRG 5883
|
| Min. Negotiated Rate |
$116,148.62 |
| Max. Negotiated Rate |
$121,956.05 |
| Rate for Payer: BCBS Complete |
$121,956.05
|
| Rate for Payer: Mclaren Medicaid |
$116,148.62
|
| Rate for Payer: Meridian Medicaid |
$121,956.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$116,148.62
|
| Rate for Payer: UHCCP Medicaid |
$121,956.05
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$89,600.36
|
|
|
Service Code
|
APR-DRG 5881
|
| Min. Negotiated Rate |
$85,333.68 |
| Max. Negotiated Rate |
$89,600.36 |
| Rate for Payer: BCBS Complete |
$89,600.36
|
| Rate for Payer: Mclaren Medicaid |
$85,333.68
|
| Rate for Payer: Meridian Medicaid |
$89,600.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$85,333.68
|
| Rate for Payer: UHCCP Medicaid |
$89,600.36
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$183,150.50
|
|
|
Service Code
|
APR-DRG 5884
|
| Min. Negotiated Rate |
$174,429.05 |
| Max. Negotiated Rate |
$183,150.50 |
| Rate for Payer: BCBS Complete |
$183,150.50
|
| Rate for Payer: Mclaren Medicaid |
$174,429.05
|
| Rate for Payer: Meridian Medicaid |
$183,150.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$174,429.05
|
| Rate for Payer: UHCCP Medicaid |
$183,150.50
|
|