|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$16,502.48
|
|
|
Service Code
|
APR-DRG 5911
|
| Min. Negotiated Rate |
$15,716.65 |
| Max. Negotiated Rate |
$16,502.48 |
| Rate for Payer: BCBS Complete |
$16,502.48
|
| Rate for Payer: Mclaren Medicaid |
$15,716.65
|
| Rate for Payer: Meridian Medicaid |
$16,502.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,716.65
|
| Rate for Payer: UHCCP Medicaid |
$16,502.48
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$90,574.28
|
|
|
Service Code
|
APR-DRG 5913
|
| Min. Negotiated Rate |
$86,261.22 |
| Max. Negotiated Rate |
$90,574.28 |
| Rate for Payer: BCBS Complete |
$90,574.28
|
| Rate for Payer: Mclaren Medicaid |
$86,261.22
|
| Rate for Payer: Meridian Medicaid |
$90,574.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$86,261.22
|
| Rate for Payer: UHCCP Medicaid |
$90,574.28
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$77,696.93
|
|
|
Service Code
|
APR-DRG 5912
|
| Min. Negotiated Rate |
$73,997.08 |
| Max. Negotiated Rate |
$77,696.93 |
| Rate for Payer: BCBS Complete |
$77,696.93
|
| Rate for Payer: Mclaren Medicaid |
$73,997.08
|
| Rate for Payer: Meridian Medicaid |
$77,696.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$73,997.08
|
| Rate for Payer: UHCCP Medicaid |
$77,696.93
|
|
|
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
|
$85,380.06
|
|
|
Service Code
|
APR-DRG 5891
|
| Min. Negotiated Rate |
$81,314.34 |
| Max. Negotiated Rate |
$85,380.06 |
| Rate for Payer: BCBS Complete |
$85,380.06
|
| Rate for Payer: Mclaren Medicaid |
$81,314.34
|
| Rate for Payer: Meridian Medicaid |
$85,380.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$81,314.34
|
| Rate for Payer: UHCCP Medicaid |
$85,380.06
|
|
|
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
|
$1,785.51
|
|
|
Service Code
|
APR-DRG 5894
|
| 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 < 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
|
$85,380.06
|
|
|
Service Code
|
APR-DRG 5892
|
| Min. Negotiated Rate |
$81,314.34 |
| Max. Negotiated Rate |
$85,380.06 |
| Rate for Payer: BCBS Complete |
$85,380.06
|
| Rate for Payer: Mclaren Medicaid |
$81,314.34
|
| Rate for Payer: Meridian Medicaid |
$85,380.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$81,314.34
|
| Rate for Payer: UHCCP Medicaid |
$85,380.06
|
|
|
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
|
$85,380.06
|
|
|
Service Code
|
APR-DRG 5893
|
| Min. Negotiated Rate |
$81,314.34 |
| Max. Negotiated Rate |
$85,380.06 |
| Rate for Payer: BCBS Complete |
$85,380.06
|
| Rate for Payer: Mclaren Medicaid |
$81,314.34
|
| Rate for Payer: Meridian Medicaid |
$85,380.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$81,314.34
|
| Rate for Payer: UHCCP Medicaid |
$85,380.06
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$77,209.98
|
|
|
Service Code
|
APR-DRG 5933
|
| Min. Negotiated Rate |
$73,533.31 |
| Max. Negotiated Rate |
$77,209.98 |
| Rate for Payer: BCBS Complete |
$77,209.98
|
| Rate for Payer: Mclaren Medicaid |
$73,533.31
|
| Rate for Payer: Meridian Medicaid |
$77,209.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$73,533.31
|
| Rate for Payer: UHCCP Medicaid |
$77,209.98
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$47,289.08
|
|
|
Service Code
|
APR-DRG 5931
|
| Min. Negotiated Rate |
$45,037.22 |
| Max. Negotiated Rate |
$47,289.08 |
| Rate for Payer: BCBS Complete |
$47,289.08
|
| Rate for Payer: Mclaren Medicaid |
$45,037.22
|
| Rate for Payer: Meridian Medicaid |
$47,289.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$45,037.22
|
| Rate for Payer: UHCCP Medicaid |
$47,289.08
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$62,114.26
|
|
|
Service Code
|
APR-DRG 5932
|
| Min. Negotiated Rate |
$59,156.44 |
| Max. Negotiated Rate |
$62,114.26 |
| Rate for Payer: BCBS Complete |
$62,114.26
|
| Rate for Payer: Mclaren Medicaid |
$59,156.44
|
| Rate for Payer: Meridian Medicaid |
$62,114.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$59,156.44
|
| Rate for Payer: UHCCP Medicaid |
$62,114.26
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$105,561.78
|
|
|
Service Code
|
APR-DRG 5934
|
| Min. Negotiated Rate |
$100,535.03 |
| Max. Negotiated Rate |
$105,561.78 |
| Rate for Payer: BCBS Complete |
$105,561.78
|
| Rate for Payer: Mclaren Medicaid |
$100,535.03
|
| Rate for Payer: Meridian Medicaid |
$105,561.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$100,535.03
|
| Rate for Payer: UHCCP Medicaid |
$105,561.78
|
|
|
APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$3,029.96
|
|
|
Service Code
|
APR-DRG 5814
|
| 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, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$865.70
|
|
|
Service Code
|
APR-DRG 5812
|
| Min. Negotiated Rate |
$824.48 |
| Max. Negotiated Rate |
$865.70 |
| Rate for Payer: BCBS Complete |
$865.70
|
| Rate for Payer: Mclaren Medicaid |
$824.48
|
| Rate for Payer: Meridian Medicaid |
$865.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.48
|
| Rate for Payer: UHCCP Medicaid |
$865.70
|
|
|
APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$541.07
|
|
|
Service Code
|
APR-DRG 5811
|
| Min. Negotiated Rate |
$515.30 |
| Max. Negotiated Rate |
$541.07 |
| Rate for Payer: BCBS Complete |
$541.07
|
| Rate for Payer: Mclaren Medicaid |
$515.30
|
| Rate for Payer: Meridian Medicaid |
$541.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.30
|
| Rate for Payer: UHCCP Medicaid |
$541.07
|
|
|
APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$1,677.30
|
|
|
Service Code
|
APR-DRG 5813
|
| Min. Negotiated Rate |
$1,597.43 |
| Max. Negotiated Rate |
$1,677.30 |
| Rate for Payer: BCBS Complete |
$1,677.30
|
| Rate for Payer: Mclaren Medicaid |
$1,597.43
|
| Rate for Payer: Meridian Medicaid |
$1,677.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,597.43
|
| Rate for Payer: UHCCP Medicaid |
$1,677.30
|
|
|
APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$4,977.80
|
|
|
Service Code
|
APR-DRG 5803
|
| Min. Negotiated Rate |
$4,740.76 |
| Max. Negotiated Rate |
$4,977.80 |
| Rate for Payer: BCBS Complete |
$4,977.80
|
| Rate for Payer: Mclaren Medicaid |
$4,740.76
|
| Rate for Payer: Meridian Medicaid |
$4,977.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,740.76
|
| Rate for Payer: UHCCP Medicaid |
$4,977.80
|
|
|
APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$1,623.19
|
|
|
Service Code
|
APR-DRG 5801
|
| Min. Negotiated Rate |
$1,545.90 |
| Max. Negotiated Rate |
$1,623.19 |
| Rate for Payer: BCBS Complete |
$1,623.19
|
| Rate for Payer: Mclaren Medicaid |
$1,545.90
|
| Rate for Payer: Meridian Medicaid |
$1,623.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,545.90
|
| Rate for Payer: UHCCP Medicaid |
$1,623.19
|
|
|
APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$6,384.57
|
|
|
Service Code
|
APR-DRG 5804
|
| 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, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$2,543.01
|
|
|
Service Code
|
APR-DRG 5802
|
| Min. Negotiated Rate |
$2,421.91 |
| Max. Negotiated Rate |
$2,543.01 |
| Rate for Payer: BCBS Complete |
$2,543.01
|
| Rate for Payer: Mclaren Medicaid |
$2,421.91
|
| Rate for Payer: Meridian Medicaid |
$2,543.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,421.91
|
| Rate for Payer: UHCCP Medicaid |
$2,543.01
|
|
|
APR-DRG 42.00: NEONATE WITH ECMO
|
Facility
|
IP
|
$130,775.41
|
|
|
Service Code
|
APR-DRG 5832
|
| Min. Negotiated Rate |
$124,548.01 |
| Max. Negotiated Rate |
$130,775.41 |
| Rate for Payer: BCBS Complete |
$130,775.41
|
| Rate for Payer: Mclaren Medicaid |
$124,548.01
|
| Rate for Payer: Meridian Medicaid |
$130,775.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$124,548.01
|
| Rate for Payer: UHCCP Medicaid |
$130,775.41
|
|
|
APR-DRG 42.00: NEONATE WITH ECMO
|
Facility
|
IP
|
$117,357.00
|
|
|
Service Code
|
APR-DRG 5831
|
| Min. Negotiated Rate |
$111,768.57 |
| Max. Negotiated Rate |
$117,357.00 |
| Rate for Payer: BCBS Complete |
$117,357.00
|
| Rate for Payer: Mclaren Medicaid |
$111,768.57
|
| Rate for Payer: Meridian Medicaid |
$117,357.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$111,768.57
|
| Rate for Payer: UHCCP Medicaid |
$117,357.00
|
|
|
APR-DRG 42.00: NEONATE WITH ECMO
|
Facility
|
IP
|
$170,273.16
|
|
|
Service Code
|
APR-DRG 5833
|
| Min. Negotiated Rate |
$162,164.91 |
| Max. Negotiated Rate |
$170,273.16 |
| Rate for Payer: BCBS Complete |
$170,273.16
|
| Rate for Payer: Mclaren Medicaid |
$162,164.91
|
| Rate for Payer: Meridian Medicaid |
$170,273.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$162,164.91
|
| Rate for Payer: UHCCP Medicaid |
$170,273.16
|
|
|
APR-DRG 42.00: NEONATE WITH ECMO
|
Facility
|
IP
|
$298,992.52
|
|
|
Service Code
|
APR-DRG 5834
|
| Min. Negotiated Rate |
$284,754.78 |
| Max. Negotiated Rate |
$298,992.52 |
| Rate for Payer: BCBS Complete |
$298,992.52
|
| Rate for Payer: Mclaren Medicaid |
$284,754.78
|
| Rate for Payer: Meridian Medicaid |
$298,992.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$284,754.78
|
| Rate for Payer: UHCCP Medicaid |
$298,992.52
|
|
|
APR-DRG 42.00: NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$14,879.29
|
|
|
Service Code
|
APR-DRG 4624
|
| Min. Negotiated Rate |
$14,170.75 |
| Max. Negotiated Rate |
$14,879.29 |
| Rate for Payer: BCBS Complete |
$14,879.29
|
| Rate for Payer: Mclaren Medicaid |
$14,170.75
|
| Rate for Payer: Meridian Medicaid |
$14,879.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,170.75
|
| Rate for Payer: UHCCP Medicaid |
$14,879.29
|
|
|
APR-DRG 42.00: NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$4,436.73
|
|
|
Service Code
|
APR-DRG 4622
|
| Min. Negotiated Rate |
$4,225.46 |
| Max. Negotiated Rate |
$4,436.73 |
| Rate for Payer: BCBS Complete |
$4,436.73
|
| Rate for Payer: Mclaren Medicaid |
$4,225.46
|
| Rate for Payer: Meridian Medicaid |
$4,436.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,225.46
|
| Rate for Payer: UHCCP Medicaid |
$4,436.73
|
|