|
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 MAJOR ANOMALY
|
Facility
|
IP
|
$1,244.45
|
|
|
Service Code
|
APR-DRG 6211
|
| Min. Negotiated Rate |
$1,185.19 |
| Max. Negotiated Rate |
$1,244.45 |
| Rate for Payer: BCBS Complete |
$1,244.45
|
| Rate for Payer: Mclaren Medicaid |
$1,185.19
|
| Rate for Payer: Meridian Medicaid |
$1,244.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,185.19
|
| Rate for Payer: UHCCP Medicaid |
$1,244.45
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$17,584.61
|
|
|
Service Code
|
APR-DRG 6214
|
| 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: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$8,819.36
|
|
|
Service Code
|
APR-DRG 6213
|
| 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: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$7,250.27
|
|
|
Service Code
|
APR-DRG 6212
|
| Min. Negotiated Rate |
$6,905.02 |
| Max. Negotiated Rate |
$7,250.27 |
| Rate for Payer: BCBS Complete |
$7,250.27
|
| Rate for Payer: Mclaren Medicaid |
$6,905.02
|
| Rate for Payer: Meridian Medicaid |
$7,250.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,905.02
|
| Rate for Payer: UHCCP Medicaid |
$7,250.27
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$17,422.29
|
|
|
Service Code
|
APR-DRG 6253
|
| Min. Negotiated Rate |
$16,592.66 |
| Max. Negotiated Rate |
$17,422.29 |
| Rate for Payer: BCBS Complete |
$17,422.29
|
| Rate for Payer: Mclaren Medicaid |
$16,592.66
|
| Rate for Payer: Meridian Medicaid |
$17,422.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,592.66
|
| Rate for Payer: UHCCP Medicaid |
$17,422.29
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$4,599.05
|
|
|
Service Code
|
APR-DRG 6251
|
| Min. Negotiated Rate |
$4,380.05 |
| Max. Negotiated Rate |
$4,599.05 |
| Rate for Payer: BCBS Complete |
$4,599.05
|
| Rate for Payer: Mclaren Medicaid |
$4,380.05
|
| Rate for Payer: Meridian Medicaid |
$4,599.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,380.05
|
| Rate for Payer: UHCCP Medicaid |
$4,599.05
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$37,982.76
|
|
|
Service Code
|
APR-DRG 6254
|
| Min. Negotiated Rate |
$36,174.06 |
| Max. Negotiated Rate |
$37,982.76 |
| Rate for Payer: BCBS Complete |
$37,982.76
|
| Rate for Payer: Mclaren Medicaid |
$36,174.06
|
| Rate for Payer: Meridian Medicaid |
$37,982.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$36,174.06
|
| Rate for Payer: UHCCP Medicaid |
$37,982.76
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$8,711.15
|
|
|
Service Code
|
APR-DRG 6252
|
| 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: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$19,153.70
|
|
|
Service Code
|
APR-DRG 6223
|
| Min. Negotiated Rate |
$18,241.62 |
| Max. Negotiated Rate |
$19,153.70 |
| Rate for Payer: BCBS Complete |
$19,153.70
|
| Rate for Payer: Mclaren Medicaid |
$18,241.62
|
| Rate for Payer: Meridian Medicaid |
$19,153.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,241.62
|
| Rate for Payer: UHCCP Medicaid |
$19,153.70
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$7,953.66
|
|
|
Service Code
|
APR-DRG 6222
|
| Min. Negotiated Rate |
$7,574.91 |
| Max. Negotiated Rate |
$7,953.66 |
| Rate for Payer: BCBS Complete |
$7,953.66
|
| Rate for Payer: Mclaren Medicaid |
$7,574.91
|
| Rate for Payer: Meridian Medicaid |
$7,953.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,574.91
|
| Rate for Payer: UHCCP Medicaid |
$7,953.66
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$6,276.35
|
|
|
Service Code
|
APR-DRG 6221
|
| Min. Negotiated Rate |
$5,977.48 |
| Max. Negotiated Rate |
$6,276.35 |
| Rate for Payer: BCBS Complete |
$6,276.35
|
| Rate for Payer: Mclaren Medicaid |
$5,977.48
|
| Rate for Payer: Meridian Medicaid |
$6,276.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,977.48
|
| Rate for Payer: UHCCP Medicaid |
$6,276.35
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$28,622.34
|
|
|
Service Code
|
APR-DRG 6224
|
| Min. Negotiated Rate |
$27,259.37 |
| Max. Negotiated Rate |
$28,622.34 |
| Rate for Payer: BCBS Complete |
$28,622.34
|
| Rate for Payer: Mclaren Medicaid |
$27,259.37
|
| Rate for Payer: Meridian Medicaid |
$28,622.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$27,259.37
|
| Rate for Payer: UHCCP Medicaid |
$28,622.34
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,731.41
|
|
|
Service Code
|
APR-DRG 6403
|
| Min. Negotiated Rate |
$1,648.96 |
| Max. Negotiated Rate |
$1,731.41 |
| Rate for Payer: BCBS Complete |
$1,731.41
|
| Rate for Payer: Mclaren Medicaid |
$1,648.96
|
| Rate for Payer: Meridian Medicaid |
$1,731.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,648.96
|
| Rate for Payer: UHCCP Medicaid |
$1,731.41
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$9,522.74
|
|
|
Service Code
|
APR-DRG 6404
|
| Min. Negotiated Rate |
$9,069.28 |
| Max. Negotiated Rate |
$9,522.74 |
| Rate for Payer: BCBS Complete |
$9,522.74
|
| Rate for Payer: Mclaren Medicaid |
$9,069.28
|
| Rate for Payer: Meridian Medicaid |
$9,522.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,069.28
|
| Rate for Payer: UHCCP Medicaid |
$9,522.74
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,082.13
|
|
|
Service Code
|
APR-DRG 6402
|
| Min. Negotiated Rate |
$1,030.60 |
| Max. Negotiated Rate |
$1,082.13 |
| Rate for Payer: BCBS Complete |
$1,082.13
|
| Rate for Payer: Mclaren Medicaid |
$1,030.60
|
| Rate for Payer: Meridian Medicaid |
$1,082.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,030.60
|
| Rate for Payer: UHCCP Medicaid |
$1,082.13
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$757.49
|
|
|
Service Code
|
APR-DRG 6401
|
| Min. Negotiated Rate |
$721.42 |
| Max. Negotiated Rate |
$757.49 |
| Rate for Payer: BCBS Complete |
$757.49
|
| Rate for Payer: Mclaren Medicaid |
$721.42
|
| Rate for Payer: Meridian Medicaid |
$757.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.42
|
| Rate for Payer: UHCCP Medicaid |
$757.49
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$10,009.70
|
|
|
Service Code
|
APR-DRG 6363
|
| Min. Negotiated Rate |
$9,533.05 |
| Max. Negotiated Rate |
$10,009.70 |
| Rate for Payer: BCBS Complete |
$10,009.70
|
| Rate for Payer: Mclaren Medicaid |
$9,533.05
|
| Rate for Payer: Meridian Medicaid |
$10,009.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,533.05
|
| Rate for Payer: UHCCP Medicaid |
$10,009.70
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$3,246.39
|
|
|
Service Code
|
APR-DRG 6361
|
| Min. Negotiated Rate |
$3,091.80 |
| Max. Negotiated Rate |
$3,246.39 |
| Rate for Payer: BCBS Complete |
$3,246.39
|
| Rate for Payer: Mclaren Medicaid |
$3,091.80
|
| Rate for Payer: Meridian Medicaid |
$3,246.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,091.80
|
| Rate for Payer: UHCCP Medicaid |
$3,246.39
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$6,168.14
|
|
|
Service Code
|
APR-DRG 6362
|
| Min. Negotiated Rate |
$5,874.42 |
| Max. Negotiated Rate |
$6,168.14 |
| Rate for Payer: BCBS Complete |
$6,168.14
|
| Rate for Payer: Mclaren Medicaid |
$5,874.42
|
| Rate for Payer: Meridian Medicaid |
$6,168.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,874.42
|
| Rate for Payer: UHCCP Medicaid |
$6,168.14
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$10,117.92
|
|
|
Service Code
|
APR-DRG 6364
|
| Min. Negotiated Rate |
$9,636.11 |
| Max. Negotiated Rate |
$10,117.92 |
| Rate for Payer: BCBS Complete |
$10,117.92
|
| Rate for Payer: Mclaren Medicaid |
$9,636.11
|
| Rate for Payer: Meridian Medicaid |
$10,117.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,636.11
|
| Rate for Payer: UHCCP Medicaid |
$10,117.92
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$8,981.68
|
|
|
Service Code
|
APR-DRG 6333
|
| 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: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$1,136.24
|
|
|
Service Code
|
APR-DRG 6331
|
| Min. Negotiated Rate |
$1,082.13 |
| Max. Negotiated Rate |
$1,136.24 |
| Rate for Payer: BCBS Complete |
$1,136.24
|
| Rate for Payer: Mclaren Medicaid |
$1,082.13
|
| Rate for Payer: Meridian Medicaid |
$1,136.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,082.13
|
| Rate for Payer: UHCCP Medicaid |
$1,136.24
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$23,049.37
|
|
|
Service Code
|
APR-DRG 6334
|
| Min. Negotiated Rate |
$21,951.78 |
| Max. Negotiated Rate |
$23,049.37 |
| Rate for Payer: BCBS Complete |
$23,049.37
|
| Rate for Payer: Mclaren Medicaid |
$21,951.78
|
| Rate for Payer: Meridian Medicaid |
$23,049.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,951.78
|
| Rate for Payer: UHCCP Medicaid |
$23,049.37
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$3,679.24
|
|
|
Service Code
|
APR-DRG 6332
|
| Min. Negotiated Rate |
$3,504.04 |
| Max. Negotiated Rate |
$3,679.24 |
| Rate for Payer: BCBS Complete |
$3,679.24
|
| Rate for Payer: Mclaren Medicaid |
$3,504.04
|
| Rate for Payer: Meridian Medicaid |
$3,679.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,504.04
|
| Rate for Payer: UHCCP Medicaid |
$3,679.24
|
|