|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$15,744.99
|
|
|
Service Code
|
APR-DRG 6301
|
| Min. Negotiated Rate |
$14,995.23 |
| Max. Negotiated Rate |
$15,744.99 |
| Rate for Payer: BCBS Complete |
$15,744.99
|
| Rate for Payer: Mclaren Medicaid |
$14,995.23
|
| Rate for Payer: Meridian Medicaid |
$15,744.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,995.23
|
| Rate for Payer: UHCCP Medicaid |
$15,744.99
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$125,256.55
|
|
|
Service Code
|
APR-DRG 6304
|
| Min. Negotiated Rate |
$119,291.95 |
| Max. Negotiated Rate |
$125,256.55 |
| Rate for Payer: BCBS Complete |
$125,256.55
|
| Rate for Payer: Mclaren Medicaid |
$119,291.95
|
| Rate for Payer: Meridian Medicaid |
$125,256.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$119,291.95
|
| Rate for Payer: UHCCP Medicaid |
$125,256.55
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$30,570.17
|
|
|
Service Code
|
APR-DRG 6302
|
| Min. Negotiated Rate |
$29,114.45 |
| Max. Negotiated Rate |
$30,570.17 |
| Rate for Payer: BCBS Complete |
$30,570.17
|
| Rate for Payer: Mclaren Medicaid |
$29,114.45
|
| Rate for Payer: Meridian Medicaid |
$30,570.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$29,114.45
|
| Rate for Payer: UHCCP Medicaid |
$30,570.17
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$69,310.43
|
|
|
Service Code
|
APR-DRG 6303
|
| Min. Negotiated Rate |
$66,009.93 |
| Max. Negotiated Rate |
$69,310.43 |
| Rate for Payer: BCBS Complete |
$69,310.43
|
| Rate for Payer: Mclaren Medicaid |
$66,009.93
|
| Rate for Payer: Meridian Medicaid |
$69,310.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$66,009.93
|
| Rate for Payer: UHCCP Medicaid |
$69,310.43
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$11,145.94
|
|
|
Service Code
|
APR-DRG 6312
|
| Min. Negotiated Rate |
$10,615.18 |
| Max. Negotiated Rate |
$11,145.94 |
| Rate for Payer: BCBS Complete |
$11,145.94
|
| Rate for Payer: Mclaren Medicaid |
$10,615.18
|
| Rate for Payer: Meridian Medicaid |
$11,145.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,615.18
|
| Rate for Payer: UHCCP Medicaid |
$11,145.94
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$169,894.41
|
|
|
Service Code
|
APR-DRG 6314
|
| Min. Negotiated Rate |
$161,804.20 |
| Max. Negotiated Rate |
$169,894.41 |
| Rate for Payer: BCBS Complete |
$169,894.41
|
| Rate for Payer: Mclaren Medicaid |
$161,804.20
|
| Rate for Payer: Meridian Medicaid |
$169,894.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$161,804.20
|
| Rate for Payer: UHCCP Medicaid |
$169,894.41
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$4,707.27
|
|
|
Service Code
|
APR-DRG 6311
|
| 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: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$42,798.24
|
|
|
Service Code
|
APR-DRG 6313
|
| Min. Negotiated Rate |
$40,760.23 |
| Max. Negotiated Rate |
$42,798.24 |
| Rate for Payer: BCBS Complete |
$42,798.24
|
| Rate for Payer: Mclaren Medicaid |
$40,760.23
|
| Rate for Payer: Meridian Medicaid |
$42,798.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$40,760.23
|
| Rate for Payer: UHCCP Medicaid |
$42,798.24
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$1,785.51
|
|
|
Service Code
|
APR-DRG 6391
|
| Min. Negotiated Rate |
$1,700.49 |
| Max. Negotiated Rate |
$1,785.51 |
| Rate for Payer: BCBS Complete |
$1,785.51
|
| Rate for Payer: Mclaren Medicaid |
$1,700.49
|
| Rate for Payer: Meridian Medicaid |
$1,785.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,700.49
|
| Rate for Payer: UHCCP Medicaid |
$1,785.51
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$10,226.13
|
|
|
Service Code
|
APR-DRG 6393
|
| Min. Negotiated Rate |
$9,739.17 |
| Max. Negotiated Rate |
$10,226.13 |
| Rate for Payer: BCBS Complete |
$10,226.13
|
| Rate for Payer: Mclaren Medicaid |
$9,739.17
|
| Rate for Payer: Meridian Medicaid |
$10,226.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,739.17
|
| Rate for Payer: UHCCP Medicaid |
$10,226.13
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$15,312.14
|
|
|
Service Code
|
APR-DRG 6394
|
| Min. Negotiated Rate |
$14,582.99 |
| Max. Negotiated Rate |
$15,312.14 |
| Rate for Payer: BCBS Complete |
$15,312.14
|
| Rate for Payer: Mclaren Medicaid |
$14,582.99
|
| Rate for Payer: Meridian Medicaid |
$15,312.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,582.99
|
| Rate for Payer: UHCCP Medicaid |
$15,312.14
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$3,029.96
|
|
|
Service Code
|
APR-DRG 6392
|
| Min. Negotiated Rate |
$2,885.68 |
| Max. Negotiated Rate |
$3,029.96 |
| Rate for Payer: BCBS Complete |
$3,029.96
|
| Rate for Payer: Mclaren Medicaid |
$2,885.68
|
| Rate for Payer: Meridian Medicaid |
$3,029.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,885.68
|
| Rate for Payer: UHCCP Medicaid |
$3,029.96
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$7,412.59
|
|
|
Service Code
|
APR-DRG 6343
|
| Min. Negotiated Rate |
$7,059.61 |
| Max. Negotiated Rate |
$7,412.59 |
| Rate for Payer: BCBS Complete |
$7,412.59
|
| Rate for Payer: Mclaren Medicaid |
$7,059.61
|
| Rate for Payer: Meridian Medicaid |
$7,412.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,059.61
|
| Rate for Payer: UHCCP Medicaid |
$7,412.59
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$3,516.92
|
|
|
Service Code
|
APR-DRG 6341
|
| Min. Negotiated Rate |
$3,349.45 |
| Max. Negotiated Rate |
$3,516.92 |
| Rate for Payer: BCBS Complete |
$3,516.92
|
| Rate for Payer: Mclaren Medicaid |
$3,349.45
|
| Rate for Payer: Meridian Medicaid |
$3,516.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,349.45
|
| Rate for Payer: UHCCP Medicaid |
$3,516.92
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$14,987.50
|
|
|
Service Code
|
APR-DRG 6344
|
| Min. Negotiated Rate |
$14,273.81 |
| Max. Negotiated Rate |
$14,987.50 |
| Rate for Payer: BCBS Complete |
$14,987.50
|
| Rate for Payer: Mclaren Medicaid |
$14,273.81
|
| Rate for Payer: Meridian Medicaid |
$14,987.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,273.81
|
| Rate for Payer: UHCCP Medicaid |
$14,987.50
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$4,003.88
|
|
|
Service Code
|
APR-DRG 6342
|
| Min. Negotiated Rate |
$3,813.22 |
| Max. Negotiated Rate |
$4,003.88 |
| Rate for Payer: BCBS Complete |
$4,003.88
|
| Rate for Payer: Mclaren Medicaid |
$3,813.22
|
| Rate for Payer: Meridian Medicaid |
$4,003.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,813.22
|
| Rate for Payer: UHCCP Medicaid |
$4,003.88
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$80,185.83
|
|
|
Service Code
|
APR-DRG 5912
|
| Min. Negotiated Rate |
$76,367.46 |
| Max. Negotiated Rate |
$80,185.83 |
| Rate for Payer: BCBS Complete |
$80,185.83
|
| Rate for Payer: Mclaren Medicaid |
$76,367.46
|
| Rate for Payer: Meridian Medicaid |
$80,185.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$76,367.46
|
| Rate for Payer: UHCCP Medicaid |
$80,185.83
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$15,744.99
|
|
|
Service Code
|
APR-DRG 5911
|
| Min. Negotiated Rate |
$14,995.23 |
| Max. Negotiated Rate |
$15,744.99 |
| Rate for Payer: BCBS Complete |
$15,744.99
|
| Rate for Payer: Mclaren Medicaid |
$14,995.23
|
| Rate for Payer: Meridian Medicaid |
$15,744.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,995.23
|
| Rate for Payer: UHCCP Medicaid |
$15,744.99
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$94,037.10
|
|
|
Service Code
|
APR-DRG 5913
|
| Min. Negotiated Rate |
$89,559.14 |
| Max. Negotiated Rate |
$94,037.10 |
| Rate for Payer: BCBS Complete |
$94,037.10
|
| Rate for Payer: Mclaren Medicaid |
$89,559.14
|
| Rate for Payer: Meridian Medicaid |
$94,037.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$89,559.14
|
| Rate for Payer: UHCCP Medicaid |
$94,037.10
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$120,332.86
|
|
|
Service Code
|
APR-DRG 5914
|
| Min. Negotiated Rate |
$114,602.72 |
| Max. Negotiated Rate |
$120,332.86 |
| Rate for Payer: BCBS Complete |
$120,332.86
|
| Rate for Payer: Mclaren Medicaid |
$114,602.72
|
| Rate for Payer: Meridian Medicaid |
$120,332.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$114,602.72
|
| Rate for Payer: UHCCP Medicaid |
$120,332.86
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION
|
Facility
|
IP
|
$95,011.01
|
|
|
Service Code
|
APR-DRG 5892
|
| Min. Negotiated Rate |
$90,486.68 |
| Max. Negotiated Rate |
$95,011.01 |
| Rate for Payer: BCBS Complete |
$95,011.01
|
| Rate for Payer: Mclaren Medicaid |
$90,486.68
|
| Rate for Payer: Meridian Medicaid |
$95,011.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$90,486.68
|
| Rate for Payer: UHCCP Medicaid |
$95,011.01
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION
|
Facility
|
IP
|
$93,712.46
|
|
|
Service Code
|
APR-DRG 5891
|
| Min. Negotiated Rate |
$89,249.96 |
| Max. Negotiated Rate |
$93,712.46 |
| Rate for Payer: BCBS Complete |
$93,712.46
|
| Rate for Payer: Mclaren Medicaid |
$89,249.96
|
| Rate for Payer: Meridian Medicaid |
$93,712.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$89,249.96
|
| Rate for Payer: UHCCP Medicaid |
$93,712.46
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION
|
Facility
|
IP
|
$1,514.98
|
|
|
Service Code
|
APR-DRG 5894
|
| Min. Negotiated Rate |
$1,442.84 |
| Max. Negotiated Rate |
$1,514.98 |
| Rate for Payer: BCBS Complete |
$1,514.98
|
| Rate for Payer: Mclaren Medicaid |
$1,442.84
|
| Rate for Payer: Meridian Medicaid |
$1,514.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,442.84
|
| Rate for Payer: UHCCP Medicaid |
$1,514.98
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION
|
Facility
|
IP
|
$95,011.01
|
|
|
Service Code
|
APR-DRG 5893
|
| Min. Negotiated Rate |
$90,486.68 |
| Max. Negotiated Rate |
$95,011.01 |
| Rate for Payer: BCBS Complete |
$95,011.01
|
| Rate for Payer: Mclaren Medicaid |
$90,486.68
|
| Rate for Payer: Meridian Medicaid |
$95,011.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$90,486.68
|
| Rate for Payer: UHCCP Medicaid |
$95,011.01
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$115,246.84
|
|
|
Service Code
|
APR-DRG 5934
|
| Min. Negotiated Rate |
$109,758.90 |
| Max. Negotiated Rate |
$115,246.84 |
| Rate for Payer: BCBS Complete |
$115,246.84
|
| Rate for Payer: Mclaren Medicaid |
$109,758.90
|
| Rate for Payer: Meridian Medicaid |
$115,246.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$109,758.90
|
| Rate for Payer: UHCCP Medicaid |
$115,246.84
|
|