INJECTION, THERAPEUTIC (EG, LOCAL ANESTHETIC, CORTICOSTEROID), CARPAL TUNNEL
|
Facility
|
OP
|
$878.00
|
|
Service Code
|
CPT 20526
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$55.67 |
Max. Negotiated Rate |
$878.00 |
Rate for Payer: Aetna Medicare |
$274.08
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
Rate for Payer: BCBS Complete |
$151.38
|
Rate for Payer: BCBS MAPPO |
$263.54
|
Rate for Payer: BCBS Trust/PPO |
$169.96
|
Rate for Payer: BCN Medicare Advantage |
$263.54
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
Rate for Payer: Mclaren Medicaid |
$144.16
|
Rate for Payer: Mclaren Medicare |
$263.54
|
Rate for Payer: Meridian Medicaid |
$151.38
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
Rate for Payer: PACE Medicare |
$250.36
|
Rate for Payer: PACE SWMI |
$263.54
|
Rate for Payer: PHP Medicare Advantage |
$263.54
|
Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
Rate for Payer: Priority Health Medicare |
$263.54
|
Rate for Payer: Railroad Medicare Medicare |
$263.54
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$61.24
|
Rate for Payer: UHC Core |
$878.00
|
Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
Rate for Payer: UHC Exchange |
$55.67
|
Rate for Payer: UHC Medicare Advantage |
$271.45
|
Rate for Payer: VA VA |
$263.54
|
|
INPATIENT APRDRG 0041: TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE
|
Facility
|
IP
|
$33,163.88
|
|
Service Code
|
APR-DRG 0041
|
Hospital Charge Code |
APRDRG 0041
|
Min. Negotiated Rate |
$31,584.65 |
Max. Negotiated Rate |
$33,163.88 |
Rate for Payer: BCBS Complete |
$33,163.88
|
Rate for Payer: Mclaren Medicaid |
$31,584.65
|
Rate for Payer: Meridian Medicaid |
$33,163.88
|
Rate for Payer: Priority Health Choice Medicaid |
$31,584.65
|
|
INPATIENT APRDRG 0042: TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE
|
Facility
|
IP
|
$37,112.65
|
|
Service Code
|
APR-DRG 0042
|
Hospital Charge Code |
APRDRG 0042
|
Min. Negotiated Rate |
$35,345.38 |
Max. Negotiated Rate |
$37,112.65 |
Rate for Payer: BCBS Complete |
$37,112.65
|
Rate for Payer: Mclaren Medicaid |
$35,345.38
|
Rate for Payer: Meridian Medicaid |
$37,112.65
|
Rate for Payer: Priority Health Choice Medicaid |
$35,345.38
|
|
INPATIENT APRDRG 0043: TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE
|
Facility
|
IP
|
$60,354.75
|
|
Service Code
|
APR-DRG 0043
|
Hospital Charge Code |
APRDRG 0043
|
Min. Negotiated Rate |
$57,480.71 |
Max. Negotiated Rate |
$60,354.75 |
Rate for Payer: BCBS Complete |
$60,354.75
|
Rate for Payer: Mclaren Medicaid |
$57,480.71
|
Rate for Payer: Meridian Medicaid |
$60,354.75
|
Rate for Payer: Priority Health Choice Medicaid |
$57,480.71
|
|
INPATIENT APRDRG 0044: TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE
|
Facility
|
IP
|
$97,493.96
|
|
Service Code
|
APR-DRG 0044
|
Hospital Charge Code |
APRDRG 0044
|
Min. Negotiated Rate |
$92,851.39 |
Max. Negotiated Rate |
$97,493.96 |
Rate for Payer: BCBS Complete |
$97,493.96
|
Rate for Payer: Mclaren Medicaid |
$92,851.39
|
Rate for Payer: Meridian Medicaid |
$97,493.96
|
Rate for Payer: Priority Health Choice Medicaid |
$92,851.39
|
|
INPATIENT APRDRG 0051: TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE
|
Facility
|
IP
|
$17,012.11
|
|
Service Code
|
APR-DRG 0051
|
Hospital Charge Code |
APRDRG 0051
|
Min. Negotiated Rate |
$16,202.01 |
Max. Negotiated Rate |
$17,012.11 |
Rate for Payer: BCBS Complete |
$17,012.11
|
Rate for Payer: Mclaren Medicaid |
$16,202.01
|
Rate for Payer: Meridian Medicaid |
$17,012.11
|
Rate for Payer: Priority Health Choice Medicaid |
$16,202.01
|
|
INPATIENT APRDRG 0052: TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE
|
Facility
|
IP
|
$21,912.29
|
|
Service Code
|
APR-DRG 0052
|
Hospital Charge Code |
APRDRG 0052
|
Min. Negotiated Rate |
$20,868.85 |
Max. Negotiated Rate |
$21,912.29 |
Rate for Payer: BCBS Complete |
$21,912.29
|
Rate for Payer: Mclaren Medicaid |
$20,868.85
|
Rate for Payer: Meridian Medicaid |
$21,912.29
|
Rate for Payer: Priority Health Choice Medicaid |
$20,868.85
|
|
INPATIENT APRDRG 0053: TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE
|
Facility
|
IP
|
$50,211.78
|
|
Service Code
|
APR-DRG 0053
|
Hospital Charge Code |
APRDRG 0053
|
Min. Negotiated Rate |
$47,820.74 |
Max. Negotiated Rate |
$50,211.78 |
Rate for Payer: BCBS Complete |
$50,211.78
|
Rate for Payer: Mclaren Medicaid |
$47,820.74
|
Rate for Payer: Meridian Medicaid |
$50,211.78
|
Rate for Payer: Priority Health Choice Medicaid |
$47,820.74
|
|
INPATIENT APRDRG 0054: TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE
|
Facility
|
IP
|
$58,793.46
|
|
Service Code
|
APR-DRG 0054
|
Hospital Charge Code |
APRDRG 0054
|
Min. Negotiated Rate |
$55,993.77 |
Max. Negotiated Rate |
$58,793.46 |
Rate for Payer: BCBS Complete |
$58,793.46
|
Rate for Payer: Mclaren Medicaid |
$55,993.77
|
Rate for Payer: Meridian Medicaid |
$58,793.46
|
Rate for Payer: Priority Health Choice Medicaid |
$55,993.77
|
|
INPATIENT APRDRG 0071: ALLOGENEIC BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$55,193.27
|
|
Service Code
|
APR-DRG 0071
|
Hospital Charge Code |
APRDRG 0071
|
Min. Negotiated Rate |
$52,565.02 |
Max. Negotiated Rate |
$55,193.27 |
Rate for Payer: BCBS Complete |
$55,193.27
|
Rate for Payer: Mclaren Medicaid |
$52,565.02
|
Rate for Payer: Meridian Medicaid |
$55,193.27
|
Rate for Payer: Priority Health Choice Medicaid |
$52,565.02
|
|
INPATIENT APRDRG 0072: ALLOGENEIC BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$48,854.86
|
|
Service Code
|
APR-DRG 0072
|
Hospital Charge Code |
APRDRG 0072
|
Min. Negotiated Rate |
$46,528.44 |
Max. Negotiated Rate |
$48,854.86 |
Rate for Payer: BCBS Complete |
$48,854.86
|
Rate for Payer: Mclaren Medicaid |
$46,528.44
|
Rate for Payer: Meridian Medicaid |
$48,854.86
|
Rate for Payer: Priority Health Choice Medicaid |
$46,528.44
|
|
INPATIENT APRDRG 0073: ALLOGENEIC BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$60,924.51
|
|
Service Code
|
APR-DRG 0073
|
Hospital Charge Code |
APRDRG 0073
|
Min. Negotiated Rate |
$58,023.34 |
Max. Negotiated Rate |
$60,924.51 |
Rate for Payer: BCBS Complete |
$60,924.51
|
Rate for Payer: Mclaren Medicaid |
$58,023.34
|
Rate for Payer: Meridian Medicaid |
$60,924.51
|
Rate for Payer: Priority Health Choice Medicaid |
$58,023.34
|
|
INPATIENT APRDRG 0074: ALLOGENEIC BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$124,039.70
|
|
Service Code
|
APR-DRG 0074
|
Hospital Charge Code |
APRDRG 0074
|
Min. Negotiated Rate |
$118,133.05 |
Max. Negotiated Rate |
$124,039.70 |
Rate for Payer: BCBS Complete |
$124,039.70
|
Rate for Payer: Mclaren Medicaid |
$118,133.05
|
Rate for Payer: Meridian Medicaid |
$124,039.70
|
Rate for Payer: Priority Health Choice Medicaid |
$118,133.05
|
|
INPATIENT APRDRG 0081: AUTOLOGOUS BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$15,562.49
|
|
Service Code
|
APR-DRG 0081
|
Hospital Charge Code |
APRDRG 0081
|
Min. Negotiated Rate |
$14,821.42 |
Max. Negotiated Rate |
$15,562.49 |
Rate for Payer: BCBS Complete |
$15,562.49
|
Rate for Payer: Mclaren Medicaid |
$14,821.42
|
Rate for Payer: Meridian Medicaid |
$15,562.49
|
Rate for Payer: Priority Health Choice Medicaid |
$14,821.42
|
|
INPATIENT APRDRG 0082: AUTOLOGOUS BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$23,655.19
|
|
Service Code
|
APR-DRG 0082
|
Hospital Charge Code |
APRDRG 0082
|
Min. Negotiated Rate |
$22,528.75 |
Max. Negotiated Rate |
$23,655.19 |
Rate for Payer: BCBS Complete |
$23,655.19
|
Rate for Payer: Mclaren Medicaid |
$22,528.75
|
Rate for Payer: Meridian Medicaid |
$23,655.19
|
Rate for Payer: Priority Health Choice Medicaid |
$22,528.75
|
|
INPATIENT APRDRG 0083: AUTOLOGOUS BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$32,123.03
|
|
Service Code
|
APR-DRG 0083
|
Hospital Charge Code |
APRDRG 0083
|
Min. Negotiated Rate |
$30,593.36 |
Max. Negotiated Rate |
$32,123.03 |
Rate for Payer: BCBS Complete |
$32,123.03
|
Rate for Payer: Mclaren Medicaid |
$30,593.36
|
Rate for Payer: Meridian Medicaid |
$32,123.03
|
Rate for Payer: Priority Health Choice Medicaid |
$30,593.36
|
|
INPATIENT APRDRG 0084: AUTOLOGOUS BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$62,958.52
|
|
Service Code
|
APR-DRG 0084
|
Hospital Charge Code |
APRDRG 0084
|
Min. Negotiated Rate |
$59,960.50 |
Max. Negotiated Rate |
$62,958.52 |
Rate for Payer: BCBS Complete |
$62,958.52
|
Rate for Payer: Mclaren Medicaid |
$59,960.50
|
Rate for Payer: Meridian Medicaid |
$62,958.52
|
Rate for Payer: Priority Health Choice Medicaid |
$59,960.50
|
|
INPATIENT APRDRG 0091: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
|
Facility
|
IP
|
$30,493.97
|
|
Service Code
|
APR-DRG 0091
|
Hospital Charge Code |
APRDRG 0091
|
Min. Negotiated Rate |
$29,041.88 |
Max. Negotiated Rate |
$30,493.97 |
Rate for Payer: BCBS Complete |
$30,493.97
|
Rate for Payer: Mclaren Medicaid |
$29,041.88
|
Rate for Payer: Meridian Medicaid |
$30,493.97
|
Rate for Payer: Priority Health Choice Medicaid |
$29,041.88
|
|
INPATIENT APRDRG 0092: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
|
Facility
|
IP
|
$32,850.00
|
|
Service Code
|
APR-DRG 0092
|
Hospital Charge Code |
APRDRG 0092
|
Min. Negotiated Rate |
$31,285.71 |
Max. Negotiated Rate |
$32,850.00 |
Rate for Payer: BCBS Complete |
$32,850.00
|
Rate for Payer: Mclaren Medicaid |
$31,285.71
|
Rate for Payer: Meridian Medicaid |
$32,850.00
|
Rate for Payer: Priority Health Choice Medicaid |
$31,285.71
|
|
INPATIENT APRDRG 0093: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
|
Facility
|
IP
|
$45,306.72
|
|
Service Code
|
APR-DRG 0093
|
Hospital Charge Code |
APRDRG 0093
|
Min. Negotiated Rate |
$43,149.26 |
Max. Negotiated Rate |
$45,306.72 |
Rate for Payer: BCBS Complete |
$45,306.72
|
Rate for Payer: Mclaren Medicaid |
$43,149.26
|
Rate for Payer: Meridian Medicaid |
$45,306.72
|
Rate for Payer: Priority Health Choice Medicaid |
$43,149.26
|
|
INPATIENT APRDRG 0094: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
|
Facility
|
IP
|
$98,209.56
|
|
Service Code
|
APR-DRG 0094
|
Hospital Charge Code |
APRDRG 0094
|
Min. Negotiated Rate |
$93,532.91 |
Max. Negotiated Rate |
$98,209.56 |
Rate for Payer: BCBS Complete |
$98,209.56
|
Rate for Payer: Mclaren Medicaid |
$93,532.91
|
Rate for Payer: Meridian Medicaid |
$98,209.56
|
Rate for Payer: Priority Health Choice Medicaid |
$93,532.91
|
|
INPATIENT APRDRG 0111: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$34,534.35
|
|
Service Code
|
APR-DRG 0111
|
Hospital Charge Code |
APRDRG 0111
|
Min. Negotiated Rate |
$32,889.86 |
Max. Negotiated Rate |
$34,534.35 |
Rate for Payer: BCBS Complete |
$34,534.35
|
Rate for Payer: Mclaren Medicaid |
$32,889.86
|
Rate for Payer: Meridian Medicaid |
$34,534.35
|
Rate for Payer: Priority Health Choice Medicaid |
$32,889.86
|
|
INPATIENT APRDRG 0112: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$75,733.47
|
|
Service Code
|
APR-DRG 0112
|
Hospital Charge Code |
APRDRG 0112
|
Min. Negotiated Rate |
$72,127.11 |
Max. Negotiated Rate |
$75,733.47 |
Rate for Payer: BCBS Complete |
$75,733.47
|
Rate for Payer: Mclaren Medicaid |
$72,127.11
|
Rate for Payer: Meridian Medicaid |
$75,733.47
|
Rate for Payer: Priority Health Choice Medicaid |
$72,127.11
|
|
INPATIENT APRDRG 0113: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$88,202.11
|
|
Service Code
|
APR-DRG 0113
|
Hospital Charge Code |
APRDRG 0113
|
Min. Negotiated Rate |
$84,002.01 |
Max. Negotiated Rate |
$88,202.11 |
Rate for Payer: BCBS Complete |
$88,202.11
|
Rate for Payer: Mclaren Medicaid |
$84,002.01
|
Rate for Payer: Meridian Medicaid |
$88,202.11
|
Rate for Payer: Priority Health Choice Medicaid |
$84,002.01
|
|
INPATIENT APRDRG 0114: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$151,237.62
|
|
Service Code
|
APR-DRG 0114
|
Hospital Charge Code |
APRDRG 0114
|
Min. Negotiated Rate |
$144,035.83 |
Max. Negotiated Rate |
$151,237.62 |
Rate for Payer: BCBS Complete |
$151,237.62
|
Rate for Payer: Mclaren Medicaid |
$144,035.83
|
Rate for Payer: Meridian Medicaid |
$151,237.62
|
Rate for Payer: Priority Health Choice Medicaid |
$144,035.83
|
|