INPATIENT APRDRG 6341: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$3,400.69
|
|
Service Code
|
APR-DRG 6341
|
Hospital Charge Code |
APRDRG 6341
|
Min. Negotiated Rate |
$3,238.75 |
Max. Negotiated Rate |
$3,400.69 |
Rate for Payer: BCBS Complete |
$3,400.69
|
Rate for Payer: Mclaren Medicaid |
$3,238.75
|
Rate for Payer: Meridian Medicaid |
$3,400.69
|
Rate for Payer: Priority Health Choice Medicaid |
$3,238.75
|
|
INPATIENT APRDRG 6342: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$5,061.72
|
|
Service Code
|
APR-DRG 6342
|
Hospital Charge Code |
APRDRG 6342
|
Min. Negotiated Rate |
$4,820.69 |
Max. Negotiated Rate |
$5,061.72 |
Rate for Payer: BCBS Complete |
$5,061.72
|
Rate for Payer: Mclaren Medicaid |
$4,820.69
|
Rate for Payer: Meridian Medicaid |
$5,061.72
|
Rate for Payer: Priority Health Choice Medicaid |
$4,820.69
|
|
INPATIENT APRDRG 6343: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$5,323.57
|
|
Service Code
|
APR-DRG 6343
|
Hospital Charge Code |
APRDRG 6343
|
Min. Negotiated Rate |
$5,070.07 |
Max. Negotiated Rate |
$5,323.57 |
Rate for Payer: BCBS Complete |
$5,323.57
|
Rate for Payer: Mclaren Medicaid |
$5,070.07
|
Rate for Payer: Meridian Medicaid |
$5,323.57
|
Rate for Payer: Priority Health Choice Medicaid |
$5,070.07
|
|
INPATIENT APRDRG 6344: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$15,068.62
|
|
Service Code
|
APR-DRG 6344
|
Hospital Charge Code |
APRDRG 6344
|
Min. Negotiated Rate |
$14,351.07 |
Max. Negotiated Rate |
$15,068.62 |
Rate for Payer: BCBS Complete |
$15,068.62
|
Rate for Payer: Mclaren Medicaid |
$14,351.07
|
Rate for Payer: Meridian Medicaid |
$15,068.62
|
Rate for Payer: Priority Health Choice Medicaid |
$14,351.07
|
|
INPATIENT APRDRG 6361: NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$3,150.23
|
|
Service Code
|
APR-DRG 6361
|
Hospital Charge Code |
APRDRG 6361
|
Min. Negotiated Rate |
$3,000.22 |
Max. Negotiated Rate |
$3,150.23 |
Rate for Payer: BCBS Complete |
$3,150.23
|
Rate for Payer: Mclaren Medicaid |
$3,000.22
|
Rate for Payer: Meridian Medicaid |
$3,150.23
|
Rate for Payer: Priority Health Choice Medicaid |
$3,000.22
|
|
INPATIENT APRDRG 6362: NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$6,234.87
|
|
Service Code
|
APR-DRG 6362
|
Hospital Charge Code |
APRDRG 6362
|
Min. Negotiated Rate |
$5,937.97 |
Max. Negotiated Rate |
$6,234.87 |
Rate for Payer: BCBS Complete |
$6,234.87
|
Rate for Payer: Mclaren Medicaid |
$5,937.97
|
Rate for Payer: Meridian Medicaid |
$6,234.87
|
Rate for Payer: Priority Health Choice Medicaid |
$5,937.97
|
|
INPATIENT APRDRG 6363: NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$9,986.84
|
|
Service Code
|
APR-DRG 6363
|
Hospital Charge Code |
APRDRG 6363
|
Min. Negotiated Rate |
$9,511.28 |
Max. Negotiated Rate |
$9,986.84 |
Rate for Payer: BCBS Complete |
$9,986.84
|
Rate for Payer: Mclaren Medicaid |
$9,511.28
|
Rate for Payer: Meridian Medicaid |
$9,986.84
|
Rate for Payer: Priority Health Choice Medicaid |
$9,511.28
|
|
INPATIENT APRDRG 6364: NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$13,070.94
|
|
Service Code
|
APR-DRG 6364
|
Hospital Charge Code |
APRDRG 6364
|
Min. Negotiated Rate |
$12,448.51 |
Max. Negotiated Rate |
$13,070.94 |
Rate for Payer: BCBS Complete |
$13,070.94
|
Rate for Payer: Mclaren Medicaid |
$12,448.51
|
Rate for Payer: Meridian Medicaid |
$13,070.94
|
Rate for Payer: Priority Health Choice Medicaid |
$12,448.51
|
|
INPATIENT APRDRG 6391: NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$1,762.41
|
|
Service Code
|
APR-DRG 6391
|
Hospital Charge Code |
APRDRG 6391
|
Min. Negotiated Rate |
$1,678.49 |
Max. Negotiated Rate |
$1,762.41 |
Rate for Payer: BCBS Complete |
$1,762.41
|
Rate for Payer: Mclaren Medicaid |
$1,678.49
|
Rate for Payer: Meridian Medicaid |
$1,762.41
|
Rate for Payer: Priority Health Choice Medicaid |
$1,678.49
|
|
INPATIENT APRDRG 6392: NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$3,216.37
|
|
Service Code
|
APR-DRG 6392
|
Hospital Charge Code |
APRDRG 6392
|
Min. Negotiated Rate |
$3,063.21 |
Max. Negotiated Rate |
$3,216.37 |
Rate for Payer: BCBS Complete |
$3,216.37
|
Rate for Payer: Mclaren Medicaid |
$3,063.21
|
Rate for Payer: Meridian Medicaid |
$3,216.37
|
Rate for Payer: Priority Health Choice Medicaid |
$3,063.21
|
|
INPATIENT APRDRG 6393: NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$10,408.61
|
|
Service Code
|
APR-DRG 6393
|
Hospital Charge Code |
APRDRG 6393
|
Min. Negotiated Rate |
$9,912.96 |
Max. Negotiated Rate |
$10,408.61 |
Rate for Payer: BCBS Complete |
$10,408.61
|
Rate for Payer: Mclaren Medicaid |
$9,912.96
|
Rate for Payer: Meridian Medicaid |
$10,408.61
|
Rate for Payer: Priority Health Choice Medicaid |
$9,912.96
|
|
INPATIENT APRDRG 6394: NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$16,330.12
|
|
Service Code
|
APR-DRG 6394
|
Hospital Charge Code |
APRDRG 6394
|
Min. Negotiated Rate |
$15,552.50 |
Max. Negotiated Rate |
$16,330.12 |
Rate for Payer: BCBS Complete |
$16,330.12
|
Rate for Payer: Mclaren Medicaid |
$15,552.50
|
Rate for Payer: Meridian Medicaid |
$16,330.12
|
Rate for Payer: Priority Health Choice Medicaid |
$15,552.50
|
|
INPATIENT APRDRG 6401: NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM
|
Facility
|
IP
|
$761.13
|
|
Service Code
|
APR-DRG 6401
|
Hospital Charge Code |
APRDRG 6401
|
Min. Negotiated Rate |
$724.89 |
Max. Negotiated Rate |
$761.13 |
Rate for Payer: BCBS Complete |
$761.13
|
Rate for Payer: Mclaren Medicaid |
$724.89
|
Rate for Payer: Meridian Medicaid |
$761.13
|
Rate for Payer: Priority Health Choice Medicaid |
$724.89
|
|
INPATIENT APRDRG 6402: NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM
|
Facility
|
IP
|
$1,001.83
|
|
Service Code
|
APR-DRG 6402
|
Hospital Charge Code |
APRDRG 6402
|
Min. Negotiated Rate |
$954.12 |
Max. Negotiated Rate |
$1,001.83 |
Rate for Payer: BCBS Complete |
$1,001.83
|
Rate for Payer: Mclaren Medicaid |
$954.12
|
Rate for Payer: Meridian Medicaid |
$1,001.83
|
Rate for Payer: Priority Health Choice Medicaid |
$954.12
|
|
INPATIENT APRDRG 6403: NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM
|
Facility
|
IP
|
$1,650.74
|
|
Service Code
|
APR-DRG 6403
|
Hospital Charge Code |
APRDRG 6403
|
Min. Negotiated Rate |
$1,572.13 |
Max. Negotiated Rate |
$1,650.74 |
Rate for Payer: BCBS Complete |
$1,650.74
|
Rate for Payer: Mclaren Medicaid |
$1,572.13
|
Rate for Payer: Meridian Medicaid |
$1,650.74
|
Rate for Payer: Priority Health Choice Medicaid |
$1,572.13
|
|
INPATIENT APRDRG 6404: NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM
|
Facility
|
IP
|
$9,369.92
|
|
Service Code
|
APR-DRG 6404
|
Hospital Charge Code |
APRDRG 6404
|
Min. Negotiated Rate |
$8,923.73 |
Max. Negotiated Rate |
$9,369.92 |
Rate for Payer: BCBS Complete |
$9,369.92
|
Rate for Payer: Mclaren Medicaid |
$8,923.73
|
Rate for Payer: Meridian Medicaid |
$9,369.92
|
Rate for Payer: Priority Health Choice Medicaid |
$8,923.73
|
|
INPATIENT APRDRG 6501: SPLENECTOMY
|
Facility
|
IP
|
$8,442.90
|
|
Service Code
|
APR-DRG 6501
|
Hospital Charge Code |
APRDRG 6501
|
Min. Negotiated Rate |
$8,040.86 |
Max. Negotiated Rate |
$8,442.90 |
Rate for Payer: BCBS Complete |
$8,442.90
|
Rate for Payer: Mclaren Medicaid |
$8,040.86
|
Rate for Payer: Meridian Medicaid |
$8,442.90
|
Rate for Payer: Priority Health Choice Medicaid |
$8,040.86
|
|
INPATIENT APRDRG 6502: SPLENECTOMY
|
Facility
|
IP
|
$10,947.47
|
|
Service Code
|
APR-DRG 6502
|
Hospital Charge Code |
APRDRG 6502
|
Min. Negotiated Rate |
$10,426.16 |
Max. Negotiated Rate |
$10,947.47 |
Rate for Payer: BCBS Complete |
$10,947.47
|
Rate for Payer: Mclaren Medicaid |
$10,426.16
|
Rate for Payer: Meridian Medicaid |
$10,947.47
|
Rate for Payer: Priority Health Choice Medicaid |
$10,426.16
|
|
INPATIENT APRDRG 6503: SPLENECTOMY
|
Facility
|
IP
|
$14,737.40
|
|
Service Code
|
APR-DRG 6503
|
Hospital Charge Code |
APRDRG 6503
|
Min. Negotiated Rate |
$14,035.62 |
Max. Negotiated Rate |
$14,737.40 |
Rate for Payer: BCBS Complete |
$14,737.40
|
Rate for Payer: Mclaren Medicaid |
$14,035.62
|
Rate for Payer: Meridian Medicaid |
$14,737.40
|
Rate for Payer: Priority Health Choice Medicaid |
$14,035.62
|
|
INPATIENT APRDRG 6504: SPLENECTOMY
|
Facility
|
IP
|
$23,565.19
|
|
Service Code
|
APR-DRG 6504
|
Hospital Charge Code |
APRDRG 6504
|
Min. Negotiated Rate |
$22,443.04 |
Max. Negotiated Rate |
$23,565.19 |
Rate for Payer: BCBS Complete |
$23,565.19
|
Rate for Payer: Mclaren Medicaid |
$22,443.04
|
Rate for Payer: Meridian Medicaid |
$23,565.19
|
Rate for Payer: Priority Health Choice Medicaid |
$22,443.04
|
|
INPATIENT APRDRG 6511: OTHER PROCEDURES OF BLOOD & BLOOD-FORMING ORGANS
|
Facility
|
IP
|
$6,727.11
|
|
Service Code
|
APR-DRG 6511
|
Hospital Charge Code |
APRDRG 6511
|
Min. Negotiated Rate |
$6,406.77 |
Max. Negotiated Rate |
$6,727.11 |
Rate for Payer: BCBS Complete |
$6,727.11
|
Rate for Payer: Mclaren Medicaid |
$6,406.77
|
Rate for Payer: Meridian Medicaid |
$6,727.11
|
Rate for Payer: Priority Health Choice Medicaid |
$6,406.77
|
|
INPATIENT APRDRG 6512: OTHER PROCEDURES OF BLOOD & BLOOD-FORMING ORGANS
|
Facility
|
IP
|
$9,817.70
|
|
Service Code
|
APR-DRG 6512
|
Hospital Charge Code |
APRDRG 6512
|
Min. Negotiated Rate |
$9,350.19 |
Max. Negotiated Rate |
$9,817.70 |
Rate for Payer: BCBS Complete |
$9,817.70
|
Rate for Payer: Mclaren Medicaid |
$9,350.19
|
Rate for Payer: Meridian Medicaid |
$9,817.70
|
Rate for Payer: Priority Health Choice Medicaid |
$9,350.19
|
|
INPATIENT APRDRG 6513: OTHER PROCEDURES OF BLOOD & BLOOD-FORMING ORGANS
|
Facility
|
IP
|
$15,080.55
|
|
Service Code
|
APR-DRG 6513
|
Hospital Charge Code |
APRDRG 6513
|
Min. Negotiated Rate |
$14,362.43 |
Max. Negotiated Rate |
$15,080.55 |
Rate for Payer: BCBS Complete |
$15,080.55
|
Rate for Payer: Mclaren Medicaid |
$14,362.43
|
Rate for Payer: Meridian Medicaid |
$15,080.55
|
Rate for Payer: Priority Health Choice Medicaid |
$14,362.43
|
|
INPATIENT APRDRG 6514: OTHER PROCEDURES OF BLOOD & BLOOD-FORMING ORGANS
|
Facility
|
IP
|
$32,306.80
|
|
Service Code
|
APR-DRG 6514
|
Hospital Charge Code |
APRDRG 6514
|
Min. Negotiated Rate |
$30,768.38 |
Max. Negotiated Rate |
$32,306.80 |
Rate for Payer: BCBS Complete |
$32,306.80
|
Rate for Payer: Mclaren Medicaid |
$30,768.38
|
Rate for Payer: Meridian Medicaid |
$32,306.80
|
Rate for Payer: Priority Health Choice Medicaid |
$30,768.38
|
|
INPATIENT APRDRG 6601: MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL
|
Facility
|
IP
|
$4,602.01
|
|
Service Code
|
APR-DRG 6601
|
Hospital Charge Code |
APRDRG 6601
|
Min. Negotiated Rate |
$4,382.87 |
Max. Negotiated Rate |
$4,602.01 |
Rate for Payer: BCBS Complete |
$4,602.01
|
Rate for Payer: Mclaren Medicaid |
$4,382.87
|
Rate for Payer: Meridian Medicaid |
$4,602.01
|
Rate for Payer: Priority Health Choice Medicaid |
$4,382.87
|
|