INPATIENT APRDRG 6224: NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$28,388.93
|
|
Service Code
|
APR-DRG 6224
|
Hospital Charge Code |
APRDRG 6224
|
Min. Negotiated Rate |
$27,037.08 |
Max. Negotiated Rate |
$28,388.93 |
Rate for Payer: BCBS Complete |
$28,388.93
|
Rate for Payer: Mclaren Medicaid |
$27,037.08
|
Rate for Payer: Meridian Medicaid |
$28,388.93
|
Rate for Payer: Priority Health Choice Medicaid |
$27,037.08
|
|
INPATIENT APRDRG 6231: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$3,912.45
|
|
Service Code
|
APR-DRG 6231
|
Hospital Charge Code |
APRDRG 6231
|
Min. Negotiated Rate |
$3,726.14 |
Max. Negotiated Rate |
$3,912.45 |
Rate for Payer: BCBS Complete |
$3,912.45
|
Rate for Payer: Mclaren Medicaid |
$3,726.14
|
Rate for Payer: Meridian Medicaid |
$3,912.45
|
Rate for Payer: Priority Health Choice Medicaid |
$3,726.14
|
|
INPATIENT APRDRG 6232: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$6,690.24
|
|
Service Code
|
APR-DRG 6232
|
Hospital Charge Code |
APRDRG 6232
|
Min. Negotiated Rate |
$6,371.66 |
Max. Negotiated Rate |
$6,690.24 |
Rate for Payer: BCBS Complete |
$6,690.24
|
Rate for Payer: Mclaren Medicaid |
$6,371.66
|
Rate for Payer: Meridian Medicaid |
$6,690.24
|
Rate for Payer: Priority Health Choice Medicaid |
$6,371.66
|
|
INPATIENT APRDRG 6233: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$24,491.13
|
|
Service Code
|
APR-DRG 6233
|
Hospital Charge Code |
APRDRG 6233
|
Min. Negotiated Rate |
$23,324.89 |
Max. Negotiated Rate |
$24,491.13 |
Rate for Payer: BCBS Complete |
$24,491.13
|
Rate for Payer: Mclaren Medicaid |
$23,324.89
|
Rate for Payer: Meridian Medicaid |
$24,491.13
|
Rate for Payer: Priority Health Choice Medicaid |
$23,324.89
|
|
INPATIENT APRDRG 6234: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$30,446.81
|
|
Service Code
|
APR-DRG 6234
|
Hospital Charge Code |
APRDRG 6234
|
Min. Negotiated Rate |
$28,996.96 |
Max. Negotiated Rate |
$30,446.81 |
Rate for Payer: BCBS Complete |
$30,446.81
|
Rate for Payer: Mclaren Medicaid |
$28,996.96
|
Rate for Payer: Meridian Medicaid |
$30,446.81
|
Rate for Payer: Priority Health Choice Medicaid |
$28,996.96
|
|
INPATIENT APRDRG 6251: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$5,291.58
|
|
Service Code
|
APR-DRG 6251
|
Hospital Charge Code |
APRDRG 6251
|
Min. Negotiated Rate |
$5,039.60 |
Max. Negotiated Rate |
$5,291.58 |
Rate for Payer: BCBS Complete |
$5,291.58
|
Rate for Payer: Mclaren Medicaid |
$5,039.60
|
Rate for Payer: Meridian Medicaid |
$5,291.58
|
Rate for Payer: Priority Health Choice Medicaid |
$5,039.60
|
|
INPATIENT APRDRG 6252: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$8,613.66
|
|
Service Code
|
APR-DRG 6252
|
Hospital Charge Code |
APRDRG 6252
|
Min. Negotiated Rate |
$8,203.49 |
Max. Negotiated Rate |
$8,613.66 |
Rate for Payer: BCBS Complete |
$8,613.66
|
Rate for Payer: Mclaren Medicaid |
$8,203.49
|
Rate for Payer: Meridian Medicaid |
$8,613.66
|
Rate for Payer: Priority Health Choice Medicaid |
$8,203.49
|
|
INPATIENT APRDRG 6253: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$18,369.03
|
|
Service Code
|
APR-DRG 6253
|
Hospital Charge Code |
APRDRG 6253
|
Min. Negotiated Rate |
$17,494.31 |
Max. Negotiated Rate |
$18,369.03 |
Rate for Payer: BCBS Complete |
$18,369.03
|
Rate for Payer: Mclaren Medicaid |
$17,494.31
|
Rate for Payer: Meridian Medicaid |
$18,369.03
|
Rate for Payer: Priority Health Choice Medicaid |
$17,494.31
|
|
INPATIENT APRDRG 6254: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$37,588.09
|
|
Service Code
|
APR-DRG 6254
|
Hospital Charge Code |
APRDRG 6254
|
Min. Negotiated Rate |
$35,798.18 |
Max. Negotiated Rate |
$37,588.09 |
Rate for Payer: BCBS Complete |
$37,588.09
|
Rate for Payer: Mclaren Medicaid |
$35,798.18
|
Rate for Payer: Meridian Medicaid |
$37,588.09
|
Rate for Payer: Priority Health Choice Medicaid |
$35,798.18
|
|
INPATIENT APRDRG 6261: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM
|
Facility
|
IP
|
$1,063.08
|
|
Service Code
|
APR-DRG 6261
|
Hospital Charge Code |
APRDRG 6261
|
Min. Negotiated Rate |
$1,012.46 |
Max. Negotiated Rate |
$1,063.08 |
Rate for Payer: BCBS Complete |
$1,063.08
|
Rate for Payer: Mclaren Medicaid |
$1,012.46
|
Rate for Payer: Meridian Medicaid |
$1,063.08
|
Rate for Payer: Priority Health Choice Medicaid |
$1,012.46
|
|
INPATIENT APRDRG 6262: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM
|
Facility
|
IP
|
$1,020.80
|
|
Service Code
|
APR-DRG 6262
|
Hospital Charge Code |
APRDRG 6262
|
Min. Negotiated Rate |
$972.19 |
Max. Negotiated Rate |
$1,020.80 |
Rate for Payer: BCBS Complete |
$1,020.80
|
Rate for Payer: Mclaren Medicaid |
$972.19
|
Rate for Payer: Meridian Medicaid |
$1,020.80
|
Rate for Payer: Priority Health Choice Medicaid |
$972.19
|
|
INPATIENT APRDRG 6263: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM
|
Facility
|
IP
|
$2,510.54
|
|
Service Code
|
APR-DRG 6263
|
Hospital Charge Code |
APRDRG 6263
|
Min. Negotiated Rate |
$2,390.99 |
Max. Negotiated Rate |
$2,510.54 |
Rate for Payer: BCBS Complete |
$2,510.54
|
Rate for Payer: Mclaren Medicaid |
$2,390.99
|
Rate for Payer: Meridian Medicaid |
$2,510.54
|
Rate for Payer: Priority Health Choice Medicaid |
$2,390.99
|
|
INPATIENT APRDRG 6264: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM
|
Facility
|
IP
|
$7,673.10
|
|
Service Code
|
APR-DRG 6264
|
Hospital Charge Code |
APRDRG 6264
|
Min. Negotiated Rate |
$7,307.71 |
Max. Negotiated Rate |
$7,673.10 |
Rate for Payer: BCBS Complete |
$7,673.10
|
Rate for Payer: Mclaren Medicaid |
$7,307.71
|
Rate for Payer: Meridian Medicaid |
$7,673.10
|
Rate for Payer: Priority Health Choice Medicaid |
$7,307.71
|
|
INPATIENT APRDRG 6301: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$18,672.07
|
|
Service Code
|
APR-DRG 6301
|
Hospital Charge Code |
APRDRG 6301
|
Min. Negotiated Rate |
$17,782.92 |
Max. Negotiated Rate |
$18,672.07 |
Rate for Payer: BCBS Complete |
$18,672.07
|
Rate for Payer: Mclaren Medicaid |
$17,782.92
|
Rate for Payer: Meridian Medicaid |
$18,672.07
|
Rate for Payer: Priority Health Choice Medicaid |
$17,782.92
|
|
INPATIENT APRDRG 6302: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$39,505.00
|
|
Service Code
|
APR-DRG 6302
|
Hospital Charge Code |
APRDRG 6302
|
Min. Negotiated Rate |
$37,623.81 |
Max. Negotiated Rate |
$39,505.00 |
Rate for Payer: BCBS Complete |
$39,505.00
|
Rate for Payer: Mclaren Medicaid |
$37,623.81
|
Rate for Payer: Meridian Medicaid |
$39,505.00
|
Rate for Payer: Priority Health Choice Medicaid |
$37,623.81
|
|
INPATIENT APRDRG 6303: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$71,273.49
|
|
Service Code
|
APR-DRG 6303
|
Hospital Charge Code |
APRDRG 6303
|
Min. Negotiated Rate |
$67,879.51 |
Max. Negotiated Rate |
$71,273.49 |
Rate for Payer: BCBS Complete |
$71,273.49
|
Rate for Payer: Mclaren Medicaid |
$67,879.51
|
Rate for Payer: Meridian Medicaid |
$71,273.49
|
Rate for Payer: Priority Health Choice Medicaid |
$67,879.51
|
|
INPATIENT APRDRG 6304: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$148,688.59
|
|
Service Code
|
APR-DRG 6304
|
Hospital Charge Code |
APRDRG 6304
|
Min. Negotiated Rate |
$141,608.18 |
Max. Negotiated Rate |
$148,688.59 |
Rate for Payer: BCBS Complete |
$148,688.59
|
Rate for Payer: Mclaren Medicaid |
$141,608.18
|
Rate for Payer: Meridian Medicaid |
$148,688.59
|
Rate for Payer: Priority Health Choice Medicaid |
$141,608.18
|
|
INPATIENT APRDRG 6311: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$5,049.80
|
|
Service Code
|
APR-DRG 6311
|
Hospital Charge Code |
APRDRG 6311
|
Min. Negotiated Rate |
$4,809.33 |
Max. Negotiated Rate |
$5,049.80 |
Rate for Payer: BCBS Complete |
$5,049.80
|
Rate for Payer: Mclaren Medicaid |
$4,809.33
|
Rate for Payer: Meridian Medicaid |
$5,049.80
|
Rate for Payer: Priority Health Choice Medicaid |
$4,809.33
|
|
INPATIENT APRDRG 6312: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$12,228.49
|
|
Service Code
|
APR-DRG 6312
|
Hospital Charge Code |
APRDRG 6312
|
Min. Negotiated Rate |
$11,646.18 |
Max. Negotiated Rate |
$12,228.49 |
Rate for Payer: BCBS Complete |
$12,228.49
|
Rate for Payer: Mclaren Medicaid |
$11,646.18
|
Rate for Payer: Meridian Medicaid |
$12,228.49
|
Rate for Payer: Priority Health Choice Medicaid |
$11,646.18
|
|
INPATIENT APRDRG 6313: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$41,678.34
|
|
Service Code
|
APR-DRG 6313
|
Hospital Charge Code |
APRDRG 6313
|
Min. Negotiated Rate |
$39,693.66 |
Max. Negotiated Rate |
$41,678.34 |
Rate for Payer: BCBS Complete |
$41,678.34
|
Rate for Payer: Mclaren Medicaid |
$39,693.66
|
Rate for Payer: Meridian Medicaid |
$41,678.34
|
Rate for Payer: Priority Health Choice Medicaid |
$39,693.66
|
|
INPATIENT APRDRG 6314: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$161,859.27
|
|
Service Code
|
APR-DRG 6314
|
Hospital Charge Code |
APRDRG 6314
|
Min. Negotiated Rate |
$154,151.69 |
Max. Negotiated Rate |
$161,859.27 |
Rate for Payer: BCBS Complete |
$161,859.27
|
Rate for Payer: Mclaren Medicaid |
$154,151.69
|
Rate for Payer: Meridian Medicaid |
$161,859.27
|
Rate for Payer: Priority Health Choice Medicaid |
$154,151.69
|
|
INPATIENT APRDRG 6331: NEONATE BIRTHWT >2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$1,083.15
|
|
Service Code
|
APR-DRG 6331
|
Hospital Charge Code |
APRDRG 6331
|
Min. Negotiated Rate |
$1,031.57 |
Max. Negotiated Rate |
$1,083.15 |
Rate for Payer: BCBS Complete |
$1,083.15
|
Rate for Payer: Mclaren Medicaid |
$1,031.57
|
Rate for Payer: Meridian Medicaid |
$1,083.15
|
Rate for Payer: Priority Health Choice Medicaid |
$1,031.57
|
|
INPATIENT APRDRG 6332: NEONATE BIRTHWT >2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$3,134.51
|
|
Service Code
|
APR-DRG 6332
|
Hospital Charge Code |
APRDRG 6332
|
Min. Negotiated Rate |
$2,985.25 |
Max. Negotiated Rate |
$3,134.51 |
Rate for Payer: BCBS Complete |
$3,134.51
|
Rate for Payer: Mclaren Medicaid |
$2,985.25
|
Rate for Payer: Meridian Medicaid |
$3,134.51
|
Rate for Payer: Priority Health Choice Medicaid |
$2,985.25
|
|
INPATIENT APRDRG 6333: NEONATE BIRTHWT >2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$8,969.29
|
|
Service Code
|
APR-DRG 6333
|
Hospital Charge Code |
APRDRG 6333
|
Min. Negotiated Rate |
$8,542.18 |
Max. Negotiated Rate |
$8,969.29 |
Rate for Payer: BCBS Complete |
$8,969.29
|
Rate for Payer: Mclaren Medicaid |
$8,542.18
|
Rate for Payer: Meridian Medicaid |
$8,969.29
|
Rate for Payer: Priority Health Choice Medicaid |
$8,542.18
|
|
INPATIENT APRDRG 6334: NEONATE BIRTHWT >2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$23,635.13
|
|
Service Code
|
APR-DRG 6334
|
Hospital Charge Code |
APRDRG 6334
|
Min. Negotiated Rate |
$22,509.65 |
Max. Negotiated Rate |
$23,635.13 |
Rate for Payer: BCBS Complete |
$23,635.13
|
Rate for Payer: Mclaren Medicaid |
$22,509.65
|
Rate for Payer: Meridian Medicaid |
$23,635.13
|
Rate for Payer: Priority Health Choice Medicaid |
$22,509.65
|
|