|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
IP
|
$123.80
|
|
|
Service Code
|
NDC 51672-1298-2
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.99 |
| Max. Negotiated Rate |
$111.42 |
| Rate for Payer: Aetna Commercial |
$105.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.47
|
| Rate for Payer: Cash Price |
$99.04
|
| Rate for Payer: Cofinity Commercial |
$86.66
|
| Rate for Payer: Cofinity Commercial |
$106.47
|
| Rate for Payer: Healthscope Commercial |
$111.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.23
|
| Rate for Payer: PHP Commercial |
$105.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.66
|
| Rate for Payer: Priority Health SBD |
$77.99
|
|
|
KETOROLAC 15 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$12.91
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$11.62 |
| Rate for Payer: Aetna Commercial |
$10.97
|
| Rate for Payer: Aetna Commercial |
$12.45
|
| Rate for Payer: Aetna Commercial |
$12.04
|
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.39
|
| Rate for Payer: Cash Price |
$10.33
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$11.72
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cofinity Commercial |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$12.60
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$10.26
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$9.91
|
| Rate for Payer: Cofinity Commercial |
$9.04
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Healthscope Commercial |
$11.62
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.97
|
| Rate for Payer: PHP Commercial |
$12.04
|
| Rate for Payer: PHP Commercial |
$17.60
|
| Rate for Payer: PHP Commercial |
$10.97
|
| Rate for Payer: PHP Commercial |
$12.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.26
|
| Rate for Payer: Priority Health SBD |
$13.04
|
| Rate for Payer: Priority Health SBD |
$9.23
|
| Rate for Payer: Priority Health SBD |
$8.92
|
| Rate for Payer: Priority Health SBD |
$8.13
|
|
|
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$15.14
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22473
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.54 |
| Max. Negotiated Rate |
$13.63 |
| Rate for Payer: Aetna Commercial |
$12.87
|
| Rate for Payer: Aetna Commercial |
$10.73
|
| Rate for Payer: Aetna Commercial |
$18.13
|
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$17.82
|
| Rate for Payer: Aetna Commercial |
$21.79
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.86
|
| Rate for Payer: Cash Price |
$17.06
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$17.78
|
| Rate for Payer: Cash Price |
$9.05
|
| Rate for Payer: Cash Price |
$12.11
|
| Rate for Payer: Cash Price |
$20.50
|
| Rate for Payer: Cash Price |
$21.62
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$19.12
|
| Rate for Payer: Cofinity Commercial |
$14.93
|
| Rate for Payer: Cofinity Commercial |
$7.92
|
| Rate for Payer: Cofinity Commercial |
$9.73
|
| Rate for Payer: Cofinity Commercial |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$23.24
|
| Rate for Payer: Cofinity Commercial |
$15.56
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Cofinity Commercial |
$13.02
|
| Rate for Payer: Cofinity Commercial |
$22.04
|
| Rate for Payer: Cofinity Commercial |
$17.94
|
| Rate for Payer: Cofinity Commercial |
$11.06
|
| Rate for Payer: Cofinity Commercial |
$14.68
|
| Rate for Payer: Cofinity Commercial |
$18.03
|
| Rate for Payer: Cofinity Commercial |
$10.85
|
| Rate for Payer: Cofinity Commercial |
$8.83
|
| Rate for Payer: Cofinity Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$23.07
|
| Rate for Payer: Healthscope Commercial |
$20.01
|
| Rate for Payer: Healthscope Commercial |
$24.32
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Healthscope Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$11.36
|
| Rate for Payer: Healthscope Commercial |
$13.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.97
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$18.13
|
| Rate for Payer: PHP Commercial |
$17.82
|
| Rate for Payer: PHP Commercial |
$12.87
|
| Rate for Payer: PHP Commercial |
$22.97
|
| Rate for Payer: PHP Commercial |
$21.79
|
| Rate for Payer: PHP Commercial |
$10.73
|
| Rate for Payer: PHP Commercial |
$18.90
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.83
|
| Rate for Payer: Priority Health SBD |
$13.21
|
| Rate for Payer: Priority Health SBD |
$14.00
|
| Rate for Payer: Priority Health SBD |
$9.95
|
| Rate for Payer: Priority Health SBD |
$9.54
|
| Rate for Payer: Priority Health SBD |
$16.15
|
| Rate for Payer: Priority Health SBD |
$7.95
|
| Rate for Payer: Priority Health SBD |
$7.13
|
| Rate for Payer: Priority Health SBD |
$13.44
|
| Rate for Payer: Priority Health SBD |
$17.02
|
|
|
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC
|
Facility
|
IP
|
$35,176.12
|
|
|
Service Code
|
MS-DRG 657
|
| Min. Negotiated Rate |
$13,085.57 |
| Max. Negotiated Rate |
$35,176.12 |
| Rate for Payer: Aetna Medicare |
$14,325.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,217.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,217.85
|
| Rate for Payer: BCBS MAPPO |
$13,774.28
|
| Rate for Payer: BCBS Trust/PPO |
$35,176.12
|
| Rate for Payer: BCN Medicare Advantage |
$13,774.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,774.28
|
| Rate for Payer: Mclaren Medicare |
$13,774.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,462.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,840.42
|
| Rate for Payer: PACE Medicare |
$13,085.57
|
| Rate for Payer: PACE SWMI |
$13,774.28
|
| Rate for Payer: PHP Medicare Advantage |
$13,774.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,464.12
|
| Rate for Payer: Priority Health Medicare |
$13,774.28
|
| Rate for Payer: Priority Health Narrow Network |
$21,171.30
|
| Rate for Payer: Railroad Medicare Medicare |
$13,774.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,131.43
|
| Rate for Payer: UHC Core |
$17,261.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,774.28
|
| Rate for Payer: UHC Exchange |
$18,488.11
|
| Rate for Payer: UHC Medicare Advantage |
$14,187.51
|
| Rate for Payer: VA VA |
$13,774.28
|
|
|
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC
|
Facility
|
IP
|
$63,039.90
|
|
|
Service Code
|
MS-DRG 656
|
| Min. Negotiated Rate |
$21,934.61 |
| Max. Negotiated Rate |
$63,039.90 |
| Rate for Payer: Aetna Medicare |
$24,012.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,861.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,861.32
|
| Rate for Payer: BCBS MAPPO |
$23,089.06
|
| Rate for Payer: BCBS Trust/PPO |
$63,039.90
|
| Rate for Payer: BCN Medicare Advantage |
$23,089.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,089.06
|
| Rate for Payer: Mclaren Medicare |
$23,089.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24,243.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,552.42
|
| Rate for Payer: PACE Medicare |
$21,934.61
|
| Rate for Payer: PACE SWMI |
$23,089.06
|
| Rate for Payer: PHP Medicare Advantage |
$23,089.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45,024.31
|
| Rate for Payer: Priority Health Medicare |
$23,089.06
|
| Rate for Payer: Priority Health Narrow Network |
$36,019.45
|
| Rate for Payer: Railroad Medicare Medicare |
$23,089.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47,860.95
|
| Rate for Payer: UHC Core |
$29,367.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,089.06
|
| Rate for Payer: UHC Exchange |
$31,454.44
|
| Rate for Payer: UHC Medicare Advantage |
$23,781.73
|
| Rate for Payer: VA VA |
$23,089.06
|
|
|
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$30,744.80
|
|
|
Service Code
|
MS-DRG 658
|
| Min. Negotiated Rate |
$10,596.54 |
| Max. Negotiated Rate |
$30,744.80 |
| Rate for Payer: Aetna Medicare |
$11,600.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,942.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,942.81
|
| Rate for Payer: BCBS MAPPO |
$11,154.25
|
| Rate for Payer: BCBS Trust/PPO |
$30,744.80
|
| Rate for Payer: BCN Medicare Advantage |
$11,154.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,154.25
|
| Rate for Payer: Mclaren Medicare |
$11,154.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,711.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,827.39
|
| Rate for Payer: PACE Medicare |
$10,596.54
|
| Rate for Payer: PACE SWMI |
$11,154.25
|
| Rate for Payer: PHP Medicare Advantage |
$11,154.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,243.62
|
| Rate for Payer: Priority Health Medicare |
$11,154.25
|
| Rate for Payer: Priority Health Narrow Network |
$16,994.90
|
| Rate for Payer: Railroad Medicare Medicare |
$11,154.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,582.02
|
| Rate for Payer: UHC Core |
$13,856.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,154.25
|
| Rate for Payer: UHC Exchange |
$14,841.01
|
| Rate for Payer: UHC Medicare Advantage |
$11,488.88
|
| Rate for Payer: VA VA |
$11,154.25
|
|
|
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC
|
Facility
|
IP
|
$20,530.36
|
|
|
Service Code
|
MS-DRG 660
|
| Min. Negotiated Rate |
$9,676.33 |
| Max. Negotiated Rate |
$20,530.36 |
| Rate for Payer: Aetna Medicare |
$10,593.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,732.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,732.01
|
| Rate for Payer: BCBS MAPPO |
$10,185.61
|
| Rate for Payer: BCBS Trust/PPO |
$19,723.57
|
| Rate for Payer: BCN Medicare Advantage |
$10,185.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,185.61
|
| Rate for Payer: Mclaren Medicare |
$10,185.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,694.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,713.45
|
| Rate for Payer: PACE Medicare |
$9,676.33
|
| Rate for Payer: PACE SWMI |
$10,185.61
|
| Rate for Payer: PHP Medicare Advantage |
$10,185.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,313.56
|
| Rate for Payer: Priority Health Medicare |
$10,185.61
|
| Rate for Payer: Priority Health Narrow Network |
$15,450.85
|
| Rate for Payer: Railroad Medicare Medicare |
$10,185.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,530.36
|
| Rate for Payer: UHC Core |
$12,597.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,185.61
|
| Rate for Payer: UHC Exchange |
$13,492.65
|
| Rate for Payer: UHC Medicare Advantage |
$10,491.18
|
| Rate for Payer: VA VA |
$10,185.61
|
|
|
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
|
Facility
|
IP
|
$39,491.08
|
|
|
Service Code
|
MS-DRG 659
|
| Min. Negotiated Rate |
$18,180.57 |
| Max. Negotiated Rate |
$39,491.08 |
| Rate for Payer: Aetna Medicare |
$19,902.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,921.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,921.80
|
| Rate for Payer: BCBS MAPPO |
$19,137.44
|
| Rate for Payer: BCBS Trust/PPO |
$32,169.94
|
| Rate for Payer: BCN Medicare Advantage |
$19,137.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,137.44
|
| Rate for Payer: Mclaren Medicare |
$19,137.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20,094.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,008.06
|
| Rate for Payer: PACE Medicare |
$18,180.57
|
| Rate for Payer: PACE SWMI |
$19,137.44
|
| Rate for Payer: PHP Medicare Advantage |
$19,137.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37,150.51
|
| Rate for Payer: Priority Health Medicare |
$19,137.44
|
| Rate for Payer: Priority Health Narrow Network |
$29,720.41
|
| Rate for Payer: Railroad Medicare Medicare |
$19,137.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39,491.08
|
| Rate for Payer: UHC Core |
$24,232.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,137.44
|
| Rate for Payer: UHC Exchange |
$25,953.72
|
| Rate for Payer: UHC Medicare Advantage |
$19,711.56
|
| Rate for Payer: VA VA |
$19,137.44
|
|
|
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$18,274.28
|
|
|
Service Code
|
MS-DRG 661
|
| Min. Negotiated Rate |
$7,640.94 |
| Max. Negotiated Rate |
$18,274.28 |
| Rate for Payer: Aetna Medicare |
$8,364.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,053.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,053.88
|
| Rate for Payer: BCBS MAPPO |
$8,043.10
|
| Rate for Payer: BCBS Trust/PPO |
$18,274.28
|
| Rate for Payer: BCN Medicare Advantage |
$8,043.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,043.10
|
| Rate for Payer: Mclaren Medicare |
$8,043.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,445.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,249.56
|
| Rate for Payer: PACE Medicare |
$7,640.94
|
| Rate for Payer: PACE SWMI |
$8,043.10
|
| Rate for Payer: PHP Medicare Advantage |
$8,043.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,044.46
|
| Rate for Payer: Priority Health Medicare |
$8,043.10
|
| Rate for Payer: Priority Health Narrow Network |
$12,035.57
|
| Rate for Payer: Railroad Medicare Medicare |
$8,043.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,992.29
|
| Rate for Payer: UHC Core |
$9,813.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,043.10
|
| Rate for Payer: UHC Exchange |
$10,510.21
|
| Rate for Payer: UHC Medicare Advantage |
$8,284.39
|
| Rate for Payer: VA VA |
$8,043.10
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC
|
Facility
|
IP
|
$17,914.30
|
|
|
Service Code
|
MS-DRG 689
|
| Min. Negotiated Rate |
$8,502.99 |
| Max. Negotiated Rate |
$17,914.30 |
| Rate for Payer: Aetna Medicare |
$9,308.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,188.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,188.15
|
| Rate for Payer: BCBS MAPPO |
$8,950.52
|
| Rate for Payer: BCBS Trust/PPO |
$16,060.81
|
| Rate for Payer: BCN Medicare Advantage |
$8,950.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,950.52
|
| Rate for Payer: Mclaren Medicare |
$8,950.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,398.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,293.10
|
| Rate for Payer: PACE Medicare |
$8,502.99
|
| Rate for Payer: PACE SWMI |
$8,950.52
|
| Rate for Payer: PHP Medicare Advantage |
$8,950.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,852.55
|
| Rate for Payer: Priority Health Medicare |
$8,950.52
|
| Rate for Payer: Priority Health Narrow Network |
$13,482.04
|
| Rate for Payer: Railroad Medicare Medicare |
$8,950.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,914.30
|
| Rate for Payer: UHC Core |
$10,992.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,950.52
|
| Rate for Payer: UHC Exchange |
$11,773.36
|
| Rate for Payer: UHC Medicare Advantage |
$9,219.04
|
| Rate for Payer: VA VA |
$8,950.52
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC
|
Facility
|
IP
|
$12,308.45
|
|
|
Service Code
|
MS-DRG 690
|
| Min. Negotiated Rate |
$5,988.68 |
| Max. Negotiated Rate |
$12,308.45 |
| Rate for Payer: Aetna Medicare |
$6,556.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,879.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,879.84
|
| Rate for Payer: BCBS MAPPO |
$6,303.87
|
| Rate for Payer: BCBS Trust/PPO |
$10,147.25
|
| Rate for Payer: BCN Medicare Advantage |
$6,303.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,303.87
|
| Rate for Payer: Mclaren Medicare |
$6,303.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,619.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,249.45
|
| Rate for Payer: PACE Medicare |
$5,988.68
|
| Rate for Payer: PACE SWMI |
$6,303.87
|
| Rate for Payer: PHP Medicare Advantage |
$6,303.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,578.95
|
| Rate for Payer: Priority Health Medicare |
$6,303.87
|
| Rate for Payer: Priority Health Narrow Network |
$9,263.16
|
| Rate for Payer: Railroad Medicare Medicare |
$6,303.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,308.45
|
| Rate for Payer: UHC Core |
$7,552.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,303.87
|
| Rate for Payer: UHC Exchange |
$8,089.17
|
| Rate for Payer: UHC Medicare Advantage |
$6,492.99
|
| Rate for Payer: VA VA |
$6,303.87
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITH CC
|
Facility
|
IP
|
$18,239.15
|
|
|
Service Code
|
MS-DRG 687
|
| Min. Negotiated Rate |
$7,619.73 |
| Max. Negotiated Rate |
$18,239.15 |
| Rate for Payer: Aetna Medicare |
$8,341.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,025.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,025.96
|
| Rate for Payer: BCBS MAPPO |
$8,020.77
|
| Rate for Payer: BCBS Trust/PPO |
$18,239.15
|
| Rate for Payer: BCN Medicare Advantage |
$8,020.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,020.77
|
| Rate for Payer: Mclaren Medicare |
$8,020.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,421.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,223.89
|
| Rate for Payer: PACE Medicare |
$7,619.73
|
| Rate for Payer: PACE SWMI |
$8,020.77
|
| Rate for Payer: PHP Medicare Advantage |
$8,020.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,999.97
|
| Rate for Payer: Priority Health Medicare |
$8,020.77
|
| Rate for Payer: Priority Health Narrow Network |
$11,999.98
|
| Rate for Payer: Railroad Medicare Medicare |
$8,020.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,945.01
|
| Rate for Payer: UHC Core |
$9,784.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,020.77
|
| Rate for Payer: UHC Exchange |
$10,479.13
|
| Rate for Payer: UHC Medicare Advantage |
$8,261.39
|
| Rate for Payer: VA VA |
$8,020.77
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC
|
Facility
|
IP
|
$43,276.80
|
|
|
Service Code
|
MS-DRG 686
|
| Min. Negotiated Rate |
$13,052.72 |
| Max. Negotiated Rate |
$43,276.80 |
| Rate for Payer: Aetna Medicare |
$14,289.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,174.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,174.62
|
| Rate for Payer: BCBS MAPPO |
$13,739.70
|
| Rate for Payer: BCBS Trust/PPO |
$43,276.80
|
| Rate for Payer: BCN Medicare Advantage |
$13,739.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,739.70
|
| Rate for Payer: Mclaren Medicare |
$13,739.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,426.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,800.66
|
| Rate for Payer: PACE Medicare |
$13,052.72
|
| Rate for Payer: PACE SWMI |
$13,739.70
|
| Rate for Payer: PHP Medicare Advantage |
$13,739.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,395.24
|
| Rate for Payer: Priority Health Medicare |
$13,739.70
|
| Rate for Payer: Priority Health Narrow Network |
$21,116.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13,739.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,058.21
|
| Rate for Payer: UHC Core |
$17,216.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,739.70
|
| Rate for Payer: UHC Exchange |
$18,439.99
|
| Rate for Payer: UHC Medicare Advantage |
$14,151.89
|
| Rate for Payer: VA VA |
$13,739.70
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC
|
Facility
|
IP
|
$15,024.35
|
|
|
Service Code
|
MS-DRG 688
|
| Min. Negotiated Rate |
$5,810.78 |
| Max. Negotiated Rate |
$15,024.35 |
| Rate for Payer: Aetna Medicare |
$6,361.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,645.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,645.76
|
| Rate for Payer: BCBS MAPPO |
$6,116.61
|
| Rate for Payer: BCBS Trust/PPO |
$15,024.35
|
| Rate for Payer: BCN Medicare Advantage |
$6,116.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,116.61
|
| Rate for Payer: Mclaren Medicare |
$6,116.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,422.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,034.10
|
| Rate for Payer: PACE Medicare |
$5,810.78
|
| Rate for Payer: PACE SWMI |
$6,116.61
|
| Rate for Payer: PHP Medicare Advantage |
$6,116.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,205.85
|
| Rate for Payer: Priority Health Medicare |
$6,116.61
|
| Rate for Payer: Priority Health Narrow Network |
$8,964.68
|
| Rate for Payer: Railroad Medicare Medicare |
$6,116.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,911.85
|
| Rate for Payer: UHC Core |
$7,309.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,116.61
|
| Rate for Payer: UHC Exchange |
$7,828.52
|
| Rate for Payer: UHC Medicare Advantage |
$6,300.11
|
| Rate for Payer: VA VA |
$6,116.61
|
|
|
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$18,243.78
|
|
|
Service Code
|
MS-DRG 695
|
| Min. Negotiated Rate |
$8,650.78 |
| Max. Negotiated Rate |
$18,243.78 |
| Rate for Payer: Aetna Medicare |
$9,470.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,382.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,382.60
|
| Rate for Payer: BCBS MAPPO |
$9,106.08
|
| Rate for Payer: BCBS Trust/PPO |
$15,595.28
|
| Rate for Payer: BCN Medicare Advantage |
$9,106.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,106.08
|
| Rate for Payer: Mclaren Medicare |
$9,106.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,561.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,471.99
|
| Rate for Payer: PACE Medicare |
$8,650.78
|
| Rate for Payer: PACE SWMI |
$9,106.08
|
| Rate for Payer: PHP Medicare Advantage |
$9,106.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,162.50
|
| Rate for Payer: Priority Health Medicare |
$9,106.08
|
| Rate for Payer: Priority Health Narrow Network |
$13,730.00
|
| Rate for Payer: Railroad Medicare Medicare |
$9,106.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,243.78
|
| Rate for Payer: UHC Core |
$11,194.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,106.08
|
| Rate for Payer: UHC Exchange |
$11,989.90
|
| Rate for Payer: UHC Medicare Advantage |
$9,379.26
|
| Rate for Payer: VA VA |
$9,106.08
|
|
|
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$10,557.29
|
|
|
Service Code
|
MS-DRG 696
|
| Min. Negotiated Rate |
$5,203.24 |
| Max. Negotiated Rate |
$10,557.29 |
| Rate for Payer: Aetna Medicare |
$5,696.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,846.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,846.36
|
| Rate for Payer: BCBS MAPPO |
$5,477.09
|
| Rate for Payer: BCBS Trust/PPO |
$8,588.16
|
| Rate for Payer: BCN Medicare Advantage |
$5,477.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,477.09
|
| Rate for Payer: Mclaren Medicare |
$5,477.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,750.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,298.65
|
| Rate for Payer: PACE Medicare |
$5,203.24
|
| Rate for Payer: PACE SWMI |
$5,477.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,477.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,931.58
|
| Rate for Payer: Priority Health Medicare |
$5,477.09
|
| Rate for Payer: Priority Health Narrow Network |
$7,945.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,477.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,557.29
|
| Rate for Payer: UHC Core |
$6,478.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,477.09
|
| Rate for Payer: UHC Exchange |
$6,938.30
|
| Rate for Payer: UHC Medicare Advantage |
$5,641.40
|
| Rate for Payer: VA VA |
$5,477.09
|
|
|
KIDNEY TRANSPLANT
|
Facility
|
IP
|
$134,182.67
|
|
|
Service Code
|
MS-DRG 652
|
| Min. Negotiated Rate |
$21,023.31 |
| Max. Negotiated Rate |
$134,182.67 |
| Rate for Payer: Aetna Medicare |
$23,014.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,662.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,662.25
|
| Rate for Payer: BCBS MAPPO |
$22,129.80
|
| Rate for Payer: BCBS Trust/PPO |
$134,182.67
|
| Rate for Payer: BCN Medicare Advantage |
$22,129.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,129.80
|
| Rate for Payer: Mclaren Medicare |
$22,129.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23,236.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,449.27
|
| Rate for Payer: PACE Medicare |
$21,023.31
|
| Rate for Payer: PACE SWMI |
$22,129.80
|
| Rate for Payer: PHP Medicare Advantage |
$22,129.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43,112.90
|
| Rate for Payer: Priority Health Medicare |
$22,129.80
|
| Rate for Payer: Priority Health Narrow Network |
$34,490.32
|
| Rate for Payer: Railroad Medicare Medicare |
$22,129.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45,829.12
|
| Rate for Payer: UHC Core |
$28,121.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,129.80
|
| Rate for Payer: UHC Exchange |
$30,119.11
|
| Rate for Payer: UHC Medicare Advantage |
$22,793.69
|
| Rate for Payer: VA VA |
$22,129.80
|
|
|
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC
|
Facility
|
IP
|
$168,623.16
|
|
|
Service Code
|
MS-DRG 650
|
| Min. Negotiated Rate |
$31,238.64 |
| Max. Negotiated Rate |
$168,623.16 |
| Rate for Payer: Aetna Medicare |
$34,198.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41,103.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41,103.48
|
| Rate for Payer: BCBS MAPPO |
$32,882.78
|
| Rate for Payer: BCBS Trust/PPO |
$168,623.16
|
| Rate for Payer: BCN Medicare Advantage |
$32,882.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,882.78
|
| Rate for Payer: Mclaren Medicare |
$32,882.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34,526.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,815.20
|
| Rate for Payer: PACE Medicare |
$31,238.64
|
| Rate for Payer: PACE SWMI |
$32,882.78
|
| Rate for Payer: PHP Medicare Advantage |
$32,882.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64,538.77
|
| Rate for Payer: Priority Health Medicare |
$32,882.78
|
| Rate for Payer: Priority Health Narrow Network |
$51,631.02
|
| Rate for Payer: Railroad Medicare Medicare |
$32,882.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68,604.87
|
| Rate for Payer: UHC Core |
$42,096.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,882.78
|
| Rate for Payer: UHC Exchange |
$45,087.44
|
| Rate for Payer: UHC Medicare Advantage |
$33,869.26
|
| Rate for Payer: VA VA |
$32,882.78
|
|
|
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC
|
Facility
|
IP
|
$107,656.19
|
|
|
Service Code
|
MS-DRG 651
|
| Min. Negotiated Rate |
$24,129.44 |
| Max. Negotiated Rate |
$107,656.19 |
| Rate for Payer: Aetna Medicare |
$26,415.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,749.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,749.26
|
| Rate for Payer: BCBS MAPPO |
$25,399.41
|
| Rate for Payer: BCBS Trust/PPO |
$107,656.19
|
| Rate for Payer: BCN Medicare Advantage |
$25,399.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,399.41
|
| Rate for Payer: Mclaren Medicare |
$25,399.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26,669.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,209.32
|
| Rate for Payer: PACE Medicare |
$24,129.44
|
| Rate for Payer: PACE SWMI |
$25,399.41
|
| Rate for Payer: PHP Medicare Advantage |
$25,399.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49,627.76
|
| Rate for Payer: Priority Health Medicare |
$25,399.41
|
| Rate for Payer: Priority Health Narrow Network |
$39,702.21
|
| Rate for Payer: Railroad Medicare Medicare |
$25,399.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52,754.43
|
| Rate for Payer: UHC Core |
$32,370.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,399.41
|
| Rate for Payer: UHC Exchange |
$34,670.46
|
| Rate for Payer: UHC Medicare Advantage |
$26,161.39
|
| Rate for Payer: VA VA |
$25,399.41
|
|
|
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC
|
Facility
|
IP
|
$39,370.29
|
|
|
Service Code
|
MS-DRG 488
|
| Min. Negotiated Rate |
$14,880.82 |
| Max. Negotiated Rate |
$39,370.29 |
| Rate for Payer: Aetna Medicare |
$16,290.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,580.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,580.02
|
| Rate for Payer: BCBS MAPPO |
$15,664.02
|
| Rate for Payer: BCBS Trust/PPO |
$39,370.29
|
| Rate for Payer: BCN Medicare Advantage |
$15,664.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,664.02
|
| Rate for Payer: Mclaren Medicare |
$15,664.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,447.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,013.62
|
| Rate for Payer: PACE Medicare |
$14,880.82
|
| Rate for Payer: PACE SWMI |
$15,664.02
|
| Rate for Payer: PHP Medicare Advantage |
$15,664.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,229.54
|
| Rate for Payer: Priority Health Medicare |
$15,664.02
|
| Rate for Payer: Priority Health Narrow Network |
$24,183.63
|
| Rate for Payer: Railroad Medicare Medicare |
$15,664.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,134.08
|
| Rate for Payer: UHC Core |
$19,717.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,664.02
|
| Rate for Payer: UHC Exchange |
$21,118.67
|
| Rate for Payer: UHC Medicare Advantage |
$16,133.94
|
| Rate for Payer: VA VA |
$15,664.02
|
|
|
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$23,245.80
|
|
|
Service Code
|
MS-DRG 489
|
| Min. Negotiated Rate |
$8,936.07 |
| Max. Negotiated Rate |
$23,245.80 |
| Rate for Payer: Aetna Medicare |
$9,782.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,757.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,757.99
|
| Rate for Payer: BCBS MAPPO |
$9,406.39
|
| Rate for Payer: BCBS Trust/PPO |
$23,245.80
|
| Rate for Payer: BCN Medicare Advantage |
$9,406.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,406.39
|
| Rate for Payer: Mclaren Medicare |
$9,406.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,876.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,817.35
|
| Rate for Payer: PACE Medicare |
$8,936.07
|
| Rate for Payer: PACE SWMI |
$9,406.39
|
| Rate for Payer: PHP Medicare Advantage |
$9,406.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,760.90
|
| Rate for Payer: Priority Health Medicare |
$9,406.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,208.72
|
| Rate for Payer: Railroad Medicare Medicare |
$9,406.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,879.88
|
| Rate for Payer: UHC Core |
$11,584.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,406.39
|
| Rate for Payer: UHC Exchange |
$12,407.94
|
| Rate for Payer: UHC Medicare Advantage |
$9,688.58
|
| Rate for Payer: VA VA |
$9,406.39
|
|
|
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC
|
Facility
|
IP
|
$30,634.61
|
|
|
Service Code
|
MS-DRG 486
|
| Min. Negotiated Rate |
$14,208.28 |
| Max. Negotiated Rate |
$30,634.61 |
| Rate for Payer: Aetna Medicare |
$15,554.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,695.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,695.10
|
| Rate for Payer: BCBS MAPPO |
$14,956.08
|
| Rate for Payer: BCBS Trust/PPO |
$29,719.31
|
| Rate for Payer: BCN Medicare Advantage |
$14,956.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,956.08
|
| Rate for Payer: Mclaren Medicare |
$14,956.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,703.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,199.49
|
| Rate for Payer: PACE Medicare |
$14,208.28
|
| Rate for Payer: PACE SWMI |
$14,956.08
|
| Rate for Payer: PHP Medicare Advantage |
$14,956.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,818.94
|
| Rate for Payer: Priority Health Medicare |
$14,956.08
|
| Rate for Payer: Priority Health Narrow Network |
$23,055.15
|
| Rate for Payer: Railroad Medicare Medicare |
$14,956.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,634.61
|
| Rate for Payer: UHC Core |
$18,797.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,956.08
|
| Rate for Payer: UHC Exchange |
$20,133.21
|
| Rate for Payer: UHC Medicare Advantage |
$15,404.76
|
| Rate for Payer: VA VA |
$14,956.08
|
|
|
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC
|
Facility
|
IP
|
$50,246.68
|
|
|
Service Code
|
MS-DRG 485
|
| Min. Negotiated Rate |
$23,004.66 |
| Max. Negotiated Rate |
$50,246.68 |
| Rate for Payer: Aetna Medicare |
$25,184.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,269.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,269.29
|
| Rate for Payer: BCBS MAPPO |
$24,215.43
|
| Rate for Payer: BCBS Trust/PPO |
$44,508.70
|
| Rate for Payer: BCN Medicare Advantage |
$24,215.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,215.43
|
| Rate for Payer: Mclaren Medicare |
$24,215.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25,426.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,847.74
|
| Rate for Payer: PACE Medicare |
$23,004.66
|
| Rate for Payer: PACE SWMI |
$24,215.43
|
| Rate for Payer: PHP Medicare Advantage |
$24,215.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47,268.64
|
| Rate for Payer: Priority Health Medicare |
$24,215.43
|
| Rate for Payer: Priority Health Narrow Network |
$37,814.91
|
| Rate for Payer: Railroad Medicare Medicare |
$24,215.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50,246.68
|
| Rate for Payer: UHC Core |
$30,831.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$24,215.43
|
| Rate for Payer: UHC Exchange |
$33,022.35
|
| Rate for Payer: UHC Medicare Advantage |
$24,941.89
|
| Rate for Payer: VA VA |
$24,215.43
|
|
|
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$23,565.90
|
|
|
Service Code
|
MS-DRG 487
|
| Min. Negotiated Rate |
$11,037.83 |
| Max. Negotiated Rate |
$23,565.90 |
| Rate for Payer: Aetna Medicare |
$12,083.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,523.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,523.46
|
| Rate for Payer: BCBS MAPPO |
$11,618.77
|
| Rate for Payer: BCBS Trust/PPO |
$23,463.19
|
| Rate for Payer: BCN Medicare Advantage |
$11,618.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,618.77
|
| Rate for Payer: Mclaren Medicare |
$11,618.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,199.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,361.59
|
| Rate for Payer: PACE Medicare |
$11,037.83
|
| Rate for Payer: PACE SWMI |
$11,618.77
|
| Rate for Payer: PHP Medicare Advantage |
$11,618.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,169.19
|
| Rate for Payer: Priority Health Medicare |
$11,618.77
|
| Rate for Payer: Priority Health Narrow Network |
$17,735.35
|
| Rate for Payer: Railroad Medicare Medicare |
$11,618.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,565.90
|
| Rate for Payer: UHC Core |
$14,460.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,618.77
|
| Rate for Payer: UHC Exchange |
$15,487.62
|
| Rate for Payer: UHC Medicare Advantage |
$11,967.33
|
| Rate for Payer: VA VA |
$11,618.77
|
|
|
LABETALOL 200 MG TABLET
|
Facility
|
IP
|
$233.70
|
|
|
Service Code
|
NDC 0904-5929-61
|
| Hospital Charge Code |
10374
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.23 |
| Max. Negotiated Rate |
$210.33 |
| Rate for Payer: Aetna Commercial |
$198.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.90
|
| Rate for Payer: Cash Price |
$186.96
|
| Rate for Payer: Cofinity Commercial |
$163.59
|
| Rate for Payer: Cofinity Commercial |
$200.98
|
| Rate for Payer: Healthscope Commercial |
$210.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$198.64
|
| Rate for Payer: PHP Commercial |
$198.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.59
|
| Rate for Payer: Priority Health SBD |
$147.23
|
|
