|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$14,284.12
|
|
|
Service Code
|
APR-DRG 6364
|
| Min. Negotiated Rate |
$13,603.92 |
| Max. Negotiated Rate |
$14,284.12 |
| Rate for Payer: BCBS Complete |
$14,284.12
|
| Rate for Payer: Mclaren Medicaid |
$13,603.92
|
| Rate for Payer: Meridian Medicaid |
$14,284.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,603.92
|
| Rate for Payer: UHCCP Medicaid |
$14,284.12
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$14,284.12
|
|
|
Service Code
|
APR-DRG 6363
|
| Min. Negotiated Rate |
$13,603.92 |
| Max. Negotiated Rate |
$14,284.12 |
| Rate for Payer: BCBS Complete |
$14,284.12
|
| Rate for Payer: Mclaren Medicaid |
$13,603.92
|
| Rate for Payer: Meridian Medicaid |
$14,284.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,603.92
|
| Rate for Payer: UHCCP Medicaid |
$14,284.12
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$6,871.53
|
|
|
Service Code
|
APR-DRG 6362
|
| Min. Negotiated Rate |
$6,544.31 |
| Max. Negotiated Rate |
$6,871.53 |
| Rate for Payer: BCBS Complete |
$6,871.53
|
| Rate for Payer: Mclaren Medicaid |
$6,544.31
|
| Rate for Payer: Meridian Medicaid |
$6,871.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,544.31
|
| Rate for Payer: UHCCP Medicaid |
$6,871.53
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$4,220.31
|
|
|
Service Code
|
APR-DRG 6361
|
| Min. Negotiated Rate |
$4,019.34 |
| Max. Negotiated Rate |
$4,220.31 |
| Rate for Payer: BCBS Complete |
$4,220.31
|
| Rate for Payer: Mclaren Medicaid |
$4,019.34
|
| Rate for Payer: Meridian Medicaid |
$4,220.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,019.34
|
| Rate for Payer: UHCCP Medicaid |
$4,220.31
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$15,258.03
|
|
|
Service Code
|
APR-DRG 6333
|
| Min. Negotiated Rate |
$14,531.46 |
| Max. Negotiated Rate |
$15,258.03 |
| Rate for Payer: BCBS Complete |
$15,258.03
|
| Rate for Payer: Mclaren Medicaid |
$14,531.46
|
| Rate for Payer: Meridian Medicaid |
$15,258.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,531.46
|
| Rate for Payer: UHCCP Medicaid |
$15,258.03
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$1,352.66
|
|
|
Service Code
|
APR-DRG 6331
|
| Min. Negotiated Rate |
$1,288.25 |
| Max. Negotiated Rate |
$1,352.66 |
| Rate for Payer: BCBS Complete |
$1,352.66
|
| Rate for Payer: Mclaren Medicaid |
$1,288.25
|
| Rate for Payer: Meridian Medicaid |
$1,352.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,288.25
|
| Rate for Payer: UHCCP Medicaid |
$1,352.66
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$5,897.61
|
|
|
Service Code
|
APR-DRG 6332
|
| Min. Negotiated Rate |
$5,616.77 |
| Max. Negotiated Rate |
$5,897.61 |
| Rate for Payer: BCBS Complete |
$5,897.61
|
| Rate for Payer: Mclaren Medicaid |
$5,616.77
|
| Rate for Payer: Meridian Medicaid |
$5,897.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,616.77
|
| Rate for Payer: UHCCP Medicaid |
$5,897.61
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$40,201.13
|
|
|
Service Code
|
APR-DRG 6334
|
| Min. Negotiated Rate |
$38,286.79 |
| Max. Negotiated Rate |
$40,201.13 |
| Rate for Payer: BCBS Complete |
$40,201.13
|
| Rate for Payer: Mclaren Medicaid |
$38,286.79
|
| Rate for Payer: Meridian Medicaid |
$40,201.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$38,286.79
|
| Rate for Payer: UHCCP Medicaid |
$40,201.13
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$27,973.06
|
|
|
Service Code
|
APR-DRG 6302
|
| Min. Negotiated Rate |
$26,641.01 |
| Max. Negotiated Rate |
$27,973.06 |
| Rate for Payer: BCBS Complete |
$27,973.06
|
| Rate for Payer: Mclaren Medicaid |
$26,641.01
|
| Rate for Payer: Meridian Medicaid |
$27,973.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,641.01
|
| Rate for Payer: UHCCP Medicaid |
$27,973.06
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$111,297.07
|
|
|
Service Code
|
APR-DRG 6304
|
| Min. Negotiated Rate |
$105,997.21 |
| Max. Negotiated Rate |
$111,297.07 |
| Rate for Payer: BCBS Complete |
$111,297.07
|
| Rate for Payer: Mclaren Medicaid |
$105,997.21
|
| Rate for Payer: Meridian Medicaid |
$111,297.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$105,997.21
|
| Rate for Payer: UHCCP Medicaid |
$111,297.07
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$61,356.77
|
|
|
Service Code
|
APR-DRG 6303
|
| Min. Negotiated Rate |
$58,435.02 |
| Max. Negotiated Rate |
$61,356.77 |
| Rate for Payer: BCBS Complete |
$61,356.77
|
| Rate for Payer: Mclaren Medicaid |
$58,435.02
|
| Rate for Payer: Meridian Medicaid |
$61,356.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$58,435.02
|
| Rate for Payer: UHCCP Medicaid |
$61,356.77
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$14,500.54
|
|
|
Service Code
|
APR-DRG 6301
|
| Min. Negotiated Rate |
$13,810.04 |
| Max. Negotiated Rate |
$14,500.54 |
| Rate for Payer: BCBS Complete |
$14,500.54
|
| Rate for Payer: Mclaren Medicaid |
$13,810.04
|
| Rate for Payer: Meridian Medicaid |
$14,500.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,810.04
|
| Rate for Payer: UHCCP Medicaid |
$14,500.54
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$36,089.04
|
|
|
Service Code
|
APR-DRG 6313
|
| Min. Negotiated Rate |
$34,370.51 |
| Max. Negotiated Rate |
$36,089.04 |
| Rate for Payer: BCBS Complete |
$36,089.04
|
| Rate for Payer: Mclaren Medicaid |
$34,370.51
|
| Rate for Payer: Meridian Medicaid |
$36,089.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$34,370.51
|
| Rate for Payer: UHCCP Medicaid |
$36,089.04
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$122,713.54
|
|
|
Service Code
|
APR-DRG 6314
|
| Min. Negotiated Rate |
$116,870.04 |
| Max. Negotiated Rate |
$122,713.54 |
| Rate for Payer: BCBS Complete |
$122,713.54
|
| Rate for Payer: Mclaren Medicaid |
$116,870.04
|
| Rate for Payer: Meridian Medicaid |
$122,713.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$116,870.04
|
| Rate for Payer: UHCCP Medicaid |
$122,713.54
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$20,776.90
|
|
|
Service Code
|
APR-DRG 6312
|
| Min. Negotiated Rate |
$19,787.52 |
| Max. Negotiated Rate |
$20,776.90 |
| Rate for Payer: BCBS Complete |
$20,776.90
|
| Rate for Payer: Mclaren Medicaid |
$19,787.52
|
| Rate for Payer: Meridian Medicaid |
$20,776.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,787.52
|
| Rate for Payer: UHCCP Medicaid |
$20,776.90
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$4,166.20
|
|
|
Service Code
|
APR-DRG 6311
|
| Min. Negotiated Rate |
$3,967.81 |
| Max. Negotiated Rate |
$4,166.20 |
| Rate for Payer: BCBS Complete |
$4,166.20
|
| Rate for Payer: Mclaren Medicaid |
$3,967.81
|
| Rate for Payer: Meridian Medicaid |
$4,166.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,967.81
|
| Rate for Payer: UHCCP Medicaid |
$4,166.20
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$16,989.44
|
|
|
Service Code
|
APR-DRG 6394
|
| Min. Negotiated Rate |
$16,180.42 |
| Max. Negotiated Rate |
$16,989.44 |
| Rate for Payer: BCBS Complete |
$16,989.44
|
| Rate for Payer: Mclaren Medicaid |
$16,180.42
|
| Rate for Payer: Meridian Medicaid |
$16,989.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,180.42
|
| Rate for Payer: UHCCP Medicaid |
$16,989.44
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$2,001.94
|
|
|
Service Code
|
APR-DRG 6391
|
| Min. Negotiated Rate |
$1,906.61 |
| Max. Negotiated Rate |
$2,001.94 |
| Rate for Payer: BCBS Complete |
$2,001.94
|
| Rate for Payer: Mclaren Medicaid |
$1,906.61
|
| Rate for Payer: Meridian Medicaid |
$2,001.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,906.61
|
| Rate for Payer: UHCCP Medicaid |
$2,001.94
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$3,841.56
|
|
|
Service Code
|
APR-DRG 6392
|
| Min. Negotiated Rate |
$3,658.63 |
| Max. Negotiated Rate |
$3,841.56 |
| Rate for Payer: BCBS Complete |
$3,841.56
|
| Rate for Payer: Mclaren Medicaid |
$3,658.63
|
| Rate for Payer: Meridian Medicaid |
$3,841.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,658.63
|
| Rate for Payer: UHCCP Medicaid |
$3,841.56
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$11,308.26
|
|
|
Service Code
|
APR-DRG 6393
|
| Min. Negotiated Rate |
$10,769.77 |
| Max. Negotiated Rate |
$11,308.26 |
| Rate for Payer: BCBS Complete |
$11,308.26
|
| Rate for Payer: Mclaren Medicaid |
$10,769.77
|
| Rate for Payer: Meridian Medicaid |
$11,308.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,769.77
|
| Rate for Payer: UHCCP Medicaid |
$11,308.26
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$6,384.57
|
|
|
Service Code
|
APR-DRG 6342
|
| Min. Negotiated Rate |
$6,080.54 |
| Max. Negotiated Rate |
$6,384.57 |
| Rate for Payer: BCBS Complete |
$6,384.57
|
| Rate for Payer: Mclaren Medicaid |
$6,080.54
|
| Rate for Payer: Meridian Medicaid |
$6,384.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,080.54
|
| Rate for Payer: UHCCP Medicaid |
$6,384.57
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$3,895.67
|
|
|
Service Code
|
APR-DRG 6341
|
| Min. Negotiated Rate |
$3,710.16 |
| Max. Negotiated Rate |
$3,895.67 |
| Rate for Payer: BCBS Complete |
$3,895.67
|
| Rate for Payer: Mclaren Medicaid |
$3,710.16
|
| Rate for Payer: Meridian Medicaid |
$3,895.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,710.16
|
| Rate for Payer: UHCCP Medicaid |
$3,895.67
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$12,715.03
|
|
|
Service Code
|
APR-DRG 6343
|
| Min. Negotiated Rate |
$12,109.55 |
| Max. Negotiated Rate |
$12,715.03 |
| Rate for Payer: BCBS Complete |
$12,715.03
|
| Rate for Payer: Mclaren Medicaid |
$12,109.55
|
| Rate for Payer: Meridian Medicaid |
$12,715.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,109.55
|
| Rate for Payer: UHCCP Medicaid |
$12,715.03
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$24,347.92
|
|
|
Service Code
|
APR-DRG 6344
|
| Min. Negotiated Rate |
$23,188.50 |
| Max. Negotiated Rate |
$24,347.92 |
| Rate for Payer: BCBS Complete |
$24,347.92
|
| Rate for Payer: Mclaren Medicaid |
$23,188.50
|
| Rate for Payer: Meridian Medicaid |
$24,347.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,188.50
|
| Rate for Payer: UHCCP Medicaid |
$24,347.92
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$120,062.32
|
|
|
Service Code
|
APR-DRG 5914
|
| Min. Negotiated Rate |
$114,345.07 |
| Max. Negotiated Rate |
$120,062.32 |
| Rate for Payer: BCBS Complete |
$120,062.32
|
| Rate for Payer: Mclaren Medicaid |
$114,345.07
|
| Rate for Payer: Meridian Medicaid |
$120,062.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$114,345.07
|
| Rate for Payer: UHCCP Medicaid |
$120,062.32
|
|