INPATIENT APRDRG 5661: OTHER ANTEPARTUM DIAGNOSES
|
Facility
|
IP
|
$1,859.46
|
|
Service Code
|
APR-DRG 5661
|
Hospital Charge Code |
APRDRG 5661
|
Min. Negotiated Rate |
$1,770.91 |
Max. Negotiated Rate |
$1,859.46 |
Rate for Payer: BCBS Complete |
$1,859.46
|
Rate for Payer: Mclaren Medicaid |
$1,770.91
|
Rate for Payer: Meridian Medicaid |
$1,859.46
|
Rate for Payer: Priority Health Choice Medicaid |
$1,770.91
|
|
INPATIENT APRDRG 5662: OTHER ANTEPARTUM DIAGNOSES
|
Facility
|
IP
|
$2,415.13
|
|
Service Code
|
APR-DRG 5662
|
Hospital Charge Code |
APRDRG 5662
|
Min. Negotiated Rate |
$2,300.12 |
Max. Negotiated Rate |
$2,415.13 |
Rate for Payer: BCBS Complete |
$2,415.13
|
Rate for Payer: Mclaren Medicaid |
$2,300.12
|
Rate for Payer: Meridian Medicaid |
$2,415.13
|
Rate for Payer: Priority Health Choice Medicaid |
$2,300.12
|
|
INPATIENT APRDRG 5663: OTHER ANTEPARTUM DIAGNOSES
|
Facility
|
IP
|
$3,709.69
|
|
Service Code
|
APR-DRG 5663
|
Hospital Charge Code |
APRDRG 5663
|
Min. Negotiated Rate |
$3,533.04 |
Max. Negotiated Rate |
$3,709.69 |
Rate for Payer: BCBS Complete |
$3,709.69
|
Rate for Payer: Mclaren Medicaid |
$3,533.04
|
Rate for Payer: Meridian Medicaid |
$3,709.69
|
Rate for Payer: Priority Health Choice Medicaid |
$3,533.04
|
|
INPATIENT APRDRG 5664: OTHER ANTEPARTUM DIAGNOSES
|
Facility
|
IP
|
$6,522.19
|
|
Service Code
|
APR-DRG 5664
|
Hospital Charge Code |
APRDRG 5664
|
Min. Negotiated Rate |
$6,211.61 |
Max. Negotiated Rate |
$6,522.19 |
Rate for Payer: BCBS Complete |
$6,522.19
|
Rate for Payer: Mclaren Medicaid |
$6,211.61
|
Rate for Payer: Meridian Medicaid |
$6,522.19
|
Rate for Payer: Priority Health Choice Medicaid |
$6,211.61
|
|
INPATIENT APRDRG 5801: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$1,815.00
|
|
Service Code
|
APR-DRG 5801
|
Hospital Charge Code |
APRDRG 5801
|
Min. Negotiated Rate |
$1,728.57 |
Max. Negotiated Rate |
$1,815.00 |
Rate for Payer: BCBS Complete |
$1,815.00
|
Rate for Payer: Mclaren Medicaid |
$1,728.57
|
Rate for Payer: Meridian Medicaid |
$1,815.00
|
Rate for Payer: Priority Health Choice Medicaid |
$1,728.57
|
|
INPATIENT APRDRG 5802: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$2,595.64
|
|
Service Code
|
APR-DRG 5802
|
Hospital Charge Code |
APRDRG 5802
|
Min. Negotiated Rate |
$2,472.04 |
Max. Negotiated Rate |
$2,595.64 |
Rate for Payer: BCBS Complete |
$2,595.64
|
Rate for Payer: Mclaren Medicaid |
$2,472.04
|
Rate for Payer: Meridian Medicaid |
$2,595.64
|
Rate for Payer: Priority Health Choice Medicaid |
$2,472.04
|
|
INPATIENT APRDRG 5803: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$4,136.34
|
|
Service Code
|
APR-DRG 5803
|
Hospital Charge Code |
APRDRG 5803
|
Min. Negotiated Rate |
$3,939.37 |
Max. Negotiated Rate |
$4,136.34 |
Rate for Payer: BCBS Complete |
$4,136.34
|
Rate for Payer: Mclaren Medicaid |
$3,939.37
|
Rate for Payer: Meridian Medicaid |
$4,136.34
|
Rate for Payer: Priority Health Choice Medicaid |
$3,939.37
|
|
INPATIENT APRDRG 5804: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$6,707.59
|
|
Service Code
|
APR-DRG 5804
|
Hospital Charge Code |
APRDRG 5804
|
Min. Negotiated Rate |
$6,388.18 |
Max. Negotiated Rate |
$6,707.59 |
Rate for Payer: BCBS Complete |
$6,707.59
|
Rate for Payer: Mclaren Medicaid |
$6,388.18
|
Rate for Payer: Meridian Medicaid |
$6,707.59
|
Rate for Payer: Priority Health Choice Medicaid |
$6,388.18
|
|
INPATIENT APRDRG 5811: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$670.59
|
|
Service Code
|
APR-DRG 5811
|
Hospital Charge Code |
APRDRG 5811
|
Min. Negotiated Rate |
$638.66 |
Max. Negotiated Rate |
$670.59 |
Rate for Payer: BCBS Complete |
$670.59
|
Rate for Payer: Mclaren Medicaid |
$638.66
|
Rate for Payer: Meridian Medicaid |
$670.59
|
Rate for Payer: Priority Health Choice Medicaid |
$638.66
|
|
INPATIENT APRDRG 5812: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$1,041.40
|
|
Service Code
|
APR-DRG 5812
|
Hospital Charge Code |
APRDRG 5812
|
Min. Negotiated Rate |
$991.81 |
Max. Negotiated Rate |
$1,041.40 |
Rate for Payer: BCBS Complete |
$1,041.40
|
Rate for Payer: Mclaren Medicaid |
$991.81
|
Rate for Payer: Meridian Medicaid |
$1,041.40
|
Rate for Payer: Priority Health Choice Medicaid |
$991.81
|
|
INPATIENT APRDRG 5813: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$2,070.34
|
|
Service Code
|
APR-DRG 5813
|
Hospital Charge Code |
APRDRG 5813
|
Min. Negotiated Rate |
$1,971.75 |
Max. Negotiated Rate |
$2,070.34 |
Rate for Payer: BCBS Complete |
$2,070.34
|
Rate for Payer: Mclaren Medicaid |
$1,971.75
|
Rate for Payer: Meridian Medicaid |
$2,070.34
|
Rate for Payer: Priority Health Choice Medicaid |
$1,971.75
|
|
INPATIENT APRDRG 5814: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$10,119.12
|
|
Service Code
|
APR-DRG 5814
|
Hospital Charge Code |
APRDRG 5814
|
Min. Negotiated Rate |
$9,637.26 |
Max. Negotiated Rate |
$10,119.12 |
Rate for Payer: BCBS Complete |
$10,119.12
|
Rate for Payer: Mclaren Medicaid |
$9,637.26
|
Rate for Payer: Meridian Medicaid |
$10,119.12
|
Rate for Payer: Priority Health Choice Medicaid |
$9,637.26
|
|
INPATIENT APRDRG 5831: NEONATE W ECMO
|
Facility
|
IP
|
$79,432.86
|
|
Service Code
|
APR-DRG 5831
|
Hospital Charge Code |
APRDRG 5831
|
Min. Negotiated Rate |
$75,650.34 |
Max. Negotiated Rate |
$79,432.86 |
Rate for Payer: BCBS Complete |
$79,432.86
|
Rate for Payer: Mclaren Medicaid |
$75,650.34
|
Rate for Payer: Meridian Medicaid |
$79,432.86
|
Rate for Payer: Priority Health Choice Medicaid |
$75,650.34
|
|
INPATIENT APRDRG 5832: NEONATE W ECMO
|
Facility
|
IP
|
$109,279.54
|
|
Service Code
|
APR-DRG 5832
|
Hospital Charge Code |
APRDRG 5832
|
Min. Negotiated Rate |
$104,075.75 |
Max. Negotiated Rate |
$109,279.54 |
Rate for Payer: BCBS Complete |
$109,279.54
|
Rate for Payer: Mclaren Medicaid |
$104,075.75
|
Rate for Payer: Meridian Medicaid |
$109,279.54
|
Rate for Payer: Priority Health Choice Medicaid |
$104,075.75
|
|
INPATIENT APRDRG 5833: NEONATE W ECMO
|
Facility
|
IP
|
$197,107.05
|
|
Service Code
|
APR-DRG 5833
|
Hospital Charge Code |
APRDRG 5833
|
Min. Negotiated Rate |
$187,721.00 |
Max. Negotiated Rate |
$197,107.05 |
Rate for Payer: BCBS Complete |
$197,107.05
|
Rate for Payer: Mclaren Medicaid |
$187,721.00
|
Rate for Payer: Meridian Medicaid |
$197,107.05
|
Rate for Payer: Priority Health Choice Medicaid |
$187,721.00
|
|
INPATIENT APRDRG 5834: NEONATE W ECMO
|
Facility
|
IP
|
$304,306.50
|
|
Service Code
|
APR-DRG 5834
|
Hospital Charge Code |
APRDRG 5834
|
Min. Negotiated Rate |
$289,815.71 |
Max. Negotiated Rate |
$304,306.50 |
Rate for Payer: BCBS Complete |
$304,306.50
|
Rate for Payer: Mclaren Medicaid |
$289,815.71
|
Rate for Payer: Meridian Medicaid |
$304,306.50
|
Rate for Payer: Priority Health Choice Medicaid |
$289,815.71
|
|
INPATIENT APRDRG 5881: NEONATE BWT <1500G W MAJOR PROCEDURE
|
Facility
|
IP
|
$94,563.83
|
|
Service Code
|
APR-DRG 5881
|
Hospital Charge Code |
APRDRG 5881
|
Min. Negotiated Rate |
$90,060.79 |
Max. Negotiated Rate |
$94,563.83 |
Rate for Payer: BCBS Complete |
$94,563.83
|
Rate for Payer: Mclaren Medicaid |
$90,060.79
|
Rate for Payer: Meridian Medicaid |
$94,563.83
|
Rate for Payer: Priority Health Choice Medicaid |
$90,060.79
|
|
INPATIENT APRDRG 5882: NEONATE BWT <1500G W MAJOR PROCEDURE
|
Facility
|
IP
|
$110,325.82
|
|
Service Code
|
APR-DRG 5882
|
Hospital Charge Code |
APRDRG 5882
|
Min. Negotiated Rate |
$105,072.21 |
Max. Negotiated Rate |
$110,325.82 |
Rate for Payer: BCBS Complete |
$110,325.82
|
Rate for Payer: Mclaren Medicaid |
$105,072.21
|
Rate for Payer: Meridian Medicaid |
$110,325.82
|
Rate for Payer: Priority Health Choice Medicaid |
$105,072.21
|
|
INPATIENT APRDRG 5883: NEONATE BWT <1500G W MAJOR PROCEDURE
|
Facility
|
IP
|
$128,169.54
|
|
Service Code
|
APR-DRG 5883
|
Hospital Charge Code |
APRDRG 5883
|
Min. Negotiated Rate |
$122,066.23 |
Max. Negotiated Rate |
$128,169.54 |
Rate for Payer: BCBS Complete |
$128,169.54
|
Rate for Payer: Mclaren Medicaid |
$122,066.23
|
Rate for Payer: Meridian Medicaid |
$128,169.54
|
Rate for Payer: Priority Health Choice Medicaid |
$122,066.23
|
|
INPATIENT APRDRG 5884: NEONATE BWT <1500G W MAJOR PROCEDURE
|
Facility
|
IP
|
$198,687.32
|
|
Service Code
|
APR-DRG 5884
|
Hospital Charge Code |
APRDRG 5884
|
Min. Negotiated Rate |
$189,226.02 |
Max. Negotiated Rate |
$198,687.32 |
Rate for Payer: BCBS Complete |
$198,687.32
|
Rate for Payer: Mclaren Medicaid |
$189,226.02
|
Rate for Payer: Meridian Medicaid |
$198,687.32
|
Rate for Payer: Priority Health Choice Medicaid |
$189,226.02
|
|
INPATIENT APRDRG 5891: NEONATE BWT <500G OR GA <24 WEEKS
|
Facility
|
IP
|
$77,679.12
|
|
Service Code
|
APR-DRG 5891
|
Hospital Charge Code |
APRDRG 5891
|
Min. Negotiated Rate |
$73,980.11 |
Max. Negotiated Rate |
$77,679.12 |
Rate for Payer: BCBS Complete |
$77,679.12
|
Rate for Payer: Mclaren Medicaid |
$73,980.11
|
Rate for Payer: Meridian Medicaid |
$77,679.12
|
Rate for Payer: Priority Health Choice Medicaid |
$73,980.11
|
|
INPATIENT APRDRG 5892: NEONATE BWT <500G OR GA <24 WEEKS
|
Facility
|
IP
|
$76,429.54
|
|
Service Code
|
APR-DRG 5892
|
Hospital Charge Code |
APRDRG 5892
|
Min. Negotiated Rate |
$72,790.04 |
Max. Negotiated Rate |
$76,429.54 |
Rate for Payer: BCBS Complete |
$76,429.54
|
Rate for Payer: Mclaren Medicaid |
$72,790.04
|
Rate for Payer: Meridian Medicaid |
$76,429.54
|
Rate for Payer: Priority Health Choice Medicaid |
$72,790.04
|
|
INPATIENT APRDRG 5893: NEONATE BWT <500G OR GA <24 WEEKS
|
Facility
|
IP
|
$74,801.02
|
|
Service Code
|
APR-DRG 5893
|
Hospital Charge Code |
APRDRG 5893
|
Min. Negotiated Rate |
$71,239.07 |
Max. Negotiated Rate |
$74,801.02 |
Rate for Payer: BCBS Complete |
$74,801.02
|
Rate for Payer: Mclaren Medicaid |
$71,239.07
|
Rate for Payer: Meridian Medicaid |
$74,801.02
|
Rate for Payer: Priority Health Choice Medicaid |
$71,239.07
|
|
INPATIENT APRDRG 5894: NEONATE BWT <500G OR GA <24 WEEKS
|
Facility
|
IP
|
$2,292.60
|
|
Service Code
|
APR-DRG 5894
|
Hospital Charge Code |
APRDRG 5894
|
Min. Negotiated Rate |
$2,183.43 |
Max. Negotiated Rate |
$2,292.60 |
Rate for Payer: BCBS Complete |
$2,292.60
|
Rate for Payer: Mclaren Medicaid |
$2,183.43
|
Rate for Payer: Meridian Medicaid |
$2,292.60
|
Rate for Payer: Priority Health Choice Medicaid |
$2,183.43
|
|
INPATIENT APRDRG 5911: NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE
|
Facility
|
IP
|
$37,195.05
|
|
Service Code
|
APR-DRG 5911
|
Hospital Charge Code |
APRDRG 5911
|
Min. Negotiated Rate |
$35,423.86 |
Max. Negotiated Rate |
$37,195.05 |
Rate for Payer: BCBS Complete |
$37,195.05
|
Rate for Payer: Mclaren Medicaid |
$35,423.86
|
Rate for Payer: Meridian Medicaid |
$37,195.05
|
Rate for Payer: Priority Health Choice Medicaid |
$35,423.86
|
|