INPATIENT APRDRG 6093: NEONATE BWT 1500-2499G W MAJOR PROCEDURE
|
Facility
|
IP
|
$48,131.68
|
|
Service Code
|
APR-DRG 6093
|
Hospital Charge Code |
APRDRG 6093
|
Min. Negotiated Rate |
$45,839.70 |
Max. Negotiated Rate |
$48,131.68 |
Rate for Payer: BCBS Complete |
$48,131.68
|
Rate for Payer: Mclaren Medicaid |
$45,839.70
|
Rate for Payer: Meridian Medicaid |
$48,131.68
|
Rate for Payer: Priority Health Choice Medicaid |
$45,839.70
|
|
INPATIENT APRDRG 6094: NEONATE BWT 1500-2499G W MAJOR PROCEDURE
|
Facility
|
IP
|
$130,726.16
|
|
Service Code
|
APR-DRG 6094
|
Hospital Charge Code |
APRDRG 6094
|
Min. Negotiated Rate |
$124,501.10 |
Max. Negotiated Rate |
$130,726.16 |
Rate for Payer: BCBS Complete |
$130,726.16
|
Rate for Payer: Mclaren Medicaid |
$124,501.10
|
Rate for Payer: Meridian Medicaid |
$130,726.16
|
Rate for Payer: Priority Health Choice Medicaid |
$124,501.10
|
|
INPATIENT APRDRG 6111: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY
|
Facility
|
IP
|
$4,757.60
|
|
Service Code
|
APR-DRG 6111
|
Hospital Charge Code |
APRDRG 6111
|
Min. Negotiated Rate |
$4,531.05 |
Max. Negotiated Rate |
$4,757.60 |
Rate for Payer: BCBS Complete |
$4,757.60
|
Rate for Payer: Mclaren Medicaid |
$4,531.05
|
Rate for Payer: Meridian Medicaid |
$4,757.60
|
Rate for Payer: Priority Health Choice Medicaid |
$4,531.05
|
|
INPATIENT APRDRG 6112: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY
|
Facility
|
IP
|
$13,907.42
|
|
Service Code
|
APR-DRG 6112
|
Hospital Charge Code |
APRDRG 6112
|
Min. Negotiated Rate |
$13,245.16 |
Max. Negotiated Rate |
$13,907.42 |
Rate for Payer: BCBS Complete |
$13,907.42
|
Rate for Payer: Mclaren Medicaid |
$13,245.16
|
Rate for Payer: Meridian Medicaid |
$13,907.42
|
Rate for Payer: Priority Health Choice Medicaid |
$13,245.16
|
|
INPATIENT APRDRG 6113: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY
|
Facility
|
IP
|
$19,125.28
|
|
Service Code
|
APR-DRG 6113
|
Hospital Charge Code |
APRDRG 6113
|
Min. Negotiated Rate |
$18,214.55 |
Max. Negotiated Rate |
$19,125.28 |
Rate for Payer: BCBS Complete |
$19,125.28
|
Rate for Payer: Mclaren Medicaid |
$18,214.55
|
Rate for Payer: Meridian Medicaid |
$19,125.28
|
Rate for Payer: Priority Health Choice Medicaid |
$18,214.55
|
|
INPATIENT APRDRG 6114: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY
|
Facility
|
IP
|
$31,278.41
|
|
Service Code
|
APR-DRG 6114
|
Hospital Charge Code |
APRDRG 6114
|
Min. Negotiated Rate |
$29,788.96 |
Max. Negotiated Rate |
$31,278.41 |
Rate for Payer: BCBS Complete |
$31,278.41
|
Rate for Payer: Mclaren Medicaid |
$29,788.96
|
Rate for Payer: Meridian Medicaid |
$31,278.41
|
Rate for Payer: Priority Health Choice Medicaid |
$29,788.96
|
|
INPATIENT APRDRG 6121: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$10,623.28
|
|
Service Code
|
APR-DRG 6121
|
Hospital Charge Code |
APRDRG 6121
|
Min. Negotiated Rate |
$10,117.41 |
Max. Negotiated Rate |
$10,623.28 |
Rate for Payer: BCBS Complete |
$10,623.28
|
Rate for Payer: Mclaren Medicaid |
$10,117.41
|
Rate for Payer: Meridian Medicaid |
$10,623.28
|
Rate for Payer: Priority Health Choice Medicaid |
$10,117.41
|
|
INPATIENT APRDRG 6122: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$17,428.46
|
|
Service Code
|
APR-DRG 6122
|
Hospital Charge Code |
APRDRG 6122
|
Min. Negotiated Rate |
$16,598.53 |
Max. Negotiated Rate |
$17,428.46 |
Rate for Payer: BCBS Complete |
$17,428.46
|
Rate for Payer: Mclaren Medicaid |
$16,598.53
|
Rate for Payer: Meridian Medicaid |
$17,428.46
|
Rate for Payer: Priority Health Choice Medicaid |
$16,598.53
|
|
INPATIENT APRDRG 6123: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$29,502.98
|
|
Service Code
|
APR-DRG 6123
|
Hospital Charge Code |
APRDRG 6123
|
Min. Negotiated Rate |
$28,098.08 |
Max. Negotiated Rate |
$29,502.98 |
Rate for Payer: BCBS Complete |
$29,502.98
|
Rate for Payer: Mclaren Medicaid |
$28,098.08
|
Rate for Payer: Meridian Medicaid |
$29,502.98
|
Rate for Payer: Priority Health Choice Medicaid |
$28,098.08
|
|
INPATIENT APRDRG 6124: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$47,076.18
|
|
Service Code
|
APR-DRG 6124
|
Hospital Charge Code |
APRDRG 6124
|
Min. Negotiated Rate |
$44,834.46 |
Max. Negotiated Rate |
$47,076.18 |
Rate for Payer: BCBS Complete |
$47,076.18
|
Rate for Payer: Mclaren Medicaid |
$44,834.46
|
Rate for Payer: Meridian Medicaid |
$47,076.18
|
Rate for Payer: Priority Health Choice Medicaid |
$44,834.46
|
|
INPATIENT APRDRG 6131: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$5,247.13
|
|
Service Code
|
APR-DRG 6131
|
Hospital Charge Code |
APRDRG 6131
|
Min. Negotiated Rate |
$4,997.27 |
Max. Negotiated Rate |
$5,247.13 |
Rate for Payer: BCBS Complete |
$5,247.13
|
Rate for Payer: Mclaren Medicaid |
$4,997.27
|
Rate for Payer: Meridian Medicaid |
$5,247.13
|
Rate for Payer: Priority Health Choice Medicaid |
$4,997.27
|
|
INPATIENT APRDRG 6132: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$17,109.69
|
|
Service Code
|
APR-DRG 6132
|
Hospital Charge Code |
APRDRG 6132
|
Min. Negotiated Rate |
$16,294.94 |
Max. Negotiated Rate |
$17,109.69 |
Rate for Payer: BCBS Complete |
$17,109.69
|
Rate for Payer: Mclaren Medicaid |
$16,294.94
|
Rate for Payer: Meridian Medicaid |
$17,109.69
|
Rate for Payer: Priority Health Choice Medicaid |
$16,294.94
|
|
INPATIENT APRDRG 6133: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$29,789.22
|
|
Service Code
|
APR-DRG 6133
|
Hospital Charge Code |
APRDRG 6133
|
Min. Negotiated Rate |
$28,370.69 |
Max. Negotiated Rate |
$29,789.22 |
Rate for Payer: BCBS Complete |
$29,789.22
|
Rate for Payer: Mclaren Medicaid |
$28,370.69
|
Rate for Payer: Meridian Medicaid |
$29,789.22
|
Rate for Payer: Priority Health Choice Medicaid |
$28,370.69
|
|
INPATIENT APRDRG 6134: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$54,135.61
|
|
Service Code
|
APR-DRG 6134
|
Hospital Charge Code |
APRDRG 6134
|
Min. Negotiated Rate |
$51,557.72 |
Max. Negotiated Rate |
$54,135.61 |
Rate for Payer: BCBS Complete |
$54,135.61
|
Rate for Payer: Mclaren Medicaid |
$51,557.72
|
Rate for Payer: Meridian Medicaid |
$54,135.61
|
Rate for Payer: Priority Health Choice Medicaid |
$51,557.72
|
|
INPATIENT APRDRG 6141: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$4,323.36
|
|
Service Code
|
APR-DRG 6141
|
Hospital Charge Code |
APRDRG 6141
|
Min. Negotiated Rate |
$4,117.49 |
Max. Negotiated Rate |
$4,323.36 |
Rate for Payer: BCBS Complete |
$4,323.36
|
Rate for Payer: Mclaren Medicaid |
$4,117.49
|
Rate for Payer: Meridian Medicaid |
$4,323.36
|
Rate for Payer: Priority Health Choice Medicaid |
$4,117.49
|
|
INPATIENT APRDRG 6142: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$10,823.33
|
|
Service Code
|
APR-DRG 6142
|
Hospital Charge Code |
APRDRG 6142
|
Min. Negotiated Rate |
$10,307.93 |
Max. Negotiated Rate |
$10,823.33 |
Rate for Payer: BCBS Complete |
$10,823.33
|
Rate for Payer: Mclaren Medicaid |
$10,307.93
|
Rate for Payer: Meridian Medicaid |
$10,823.33
|
Rate for Payer: Priority Health Choice Medicaid |
$10,307.93
|
|
INPATIENT APRDRG 6143: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$21,472.64
|
|
Service Code
|
APR-DRG 6143
|
Hospital Charge Code |
APRDRG 6143
|
Min. Negotiated Rate |
$20,450.13 |
Max. Negotiated Rate |
$21,472.64 |
Rate for Payer: BCBS Complete |
$21,472.64
|
Rate for Payer: Mclaren Medicaid |
$20,450.13
|
Rate for Payer: Meridian Medicaid |
$21,472.64
|
Rate for Payer: Priority Health Choice Medicaid |
$20,450.13
|
|
INPATIENT APRDRG 6144: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$28,569.46
|
|
Service Code
|
APR-DRG 6144
|
Hospital Charge Code |
APRDRG 6144
|
Min. Negotiated Rate |
$27,209.01 |
Max. Negotiated Rate |
$28,569.46 |
Rate for Payer: BCBS Complete |
$28,569.46
|
Rate for Payer: Mclaren Medicaid |
$27,209.01
|
Rate for Payer: Meridian Medicaid |
$28,569.46
|
Rate for Payer: Priority Health Choice Medicaid |
$27,209.01
|
|
INPATIENT APRDRG 6211: NEONATE BWT 2000-2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$1,282.10
|
|
Service Code
|
APR-DRG 6211
|
Hospital Charge Code |
APRDRG 6211
|
Min. Negotiated Rate |
$1,221.05 |
Max. Negotiated Rate |
$1,282.10 |
Rate for Payer: BCBS Complete |
$1,282.10
|
Rate for Payer: Mclaren Medicaid |
$1,221.05
|
Rate for Payer: Meridian Medicaid |
$1,282.10
|
Rate for Payer: Priority Health Choice Medicaid |
$1,221.05
|
|
INPATIENT APRDRG 6212: NEONATE BWT 2000-2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$7,550.04
|
|
Service Code
|
APR-DRG 6212
|
Hospital Charge Code |
APRDRG 6212
|
Min. Negotiated Rate |
$7,190.51 |
Max. Negotiated Rate |
$7,550.04 |
Rate for Payer: BCBS Complete |
$7,550.04
|
Rate for Payer: Mclaren Medicaid |
$7,190.51
|
Rate for Payer: Meridian Medicaid |
$7,550.04
|
Rate for Payer: Priority Health Choice Medicaid |
$7,190.51
|
|
INPATIENT APRDRG 6213: NEONATE BWT 2000-2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$9,136.81
|
|
Service Code
|
APR-DRG 6213
|
Hospital Charge Code |
APRDRG 6213
|
Min. Negotiated Rate |
$8,701.72 |
Max. Negotiated Rate |
$9,136.81 |
Rate for Payer: BCBS Complete |
$9,136.81
|
Rate for Payer: Mclaren Medicaid |
$8,701.72
|
Rate for Payer: Meridian Medicaid |
$9,136.81
|
Rate for Payer: Priority Health Choice Medicaid |
$8,701.72
|
|
INPATIENT APRDRG 6214: NEONATE BWT 2000-2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$18,569.61
|
|
Service Code
|
APR-DRG 6214
|
Hospital Charge Code |
APRDRG 6214
|
Min. Negotiated Rate |
$17,685.34 |
Max. Negotiated Rate |
$18,569.61 |
Rate for Payer: BCBS Complete |
$18,569.61
|
Rate for Payer: Mclaren Medicaid |
$17,685.34
|
Rate for Payer: Meridian Medicaid |
$18,569.61
|
Rate for Payer: Priority Health Choice Medicaid |
$17,685.34
|
|
INPATIENT APRDRG 6221: NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$6,612.18
|
|
Service Code
|
APR-DRG 6221
|
Hospital Charge Code |
APRDRG 6221
|
Min. Negotiated Rate |
$6,297.31 |
Max. Negotiated Rate |
$6,612.18 |
Rate for Payer: BCBS Complete |
$6,612.18
|
Rate for Payer: Mclaren Medicaid |
$6,297.31
|
Rate for Payer: Meridian Medicaid |
$6,612.18
|
Rate for Payer: Priority Health Choice Medicaid |
$6,297.31
|
|
INPATIENT APRDRG 6222: NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$8,629.93
|
|
Service Code
|
APR-DRG 6222
|
Hospital Charge Code |
APRDRG 6222
|
Min. Negotiated Rate |
$8,218.98 |
Max. Negotiated Rate |
$8,629.93 |
Rate for Payer: BCBS Complete |
$8,629.93
|
Rate for Payer: Mclaren Medicaid |
$8,218.98
|
Rate for Payer: Meridian Medicaid |
$8,629.93
|
Rate for Payer: Priority Health Choice Medicaid |
$8,218.98
|
|
INPATIENT APRDRG 6223: NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$16,779.00
|
|
Service Code
|
APR-DRG 6223
|
Hospital Charge Code |
APRDRG 6223
|
Min. Negotiated Rate |
$15,980.00 |
Max. Negotiated Rate |
$16,779.00 |
Rate for Payer: BCBS Complete |
$16,779.00
|
Rate for Payer: Mclaren Medicaid |
$15,980.00
|
Rate for Payer: Meridian Medicaid |
$16,779.00
|
Rate for Payer: Priority Health Choice Medicaid |
$15,980.00
|
|