|
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$55.83
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
117958
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$50.25 |
| Rate for Payer: Aetna Commercial |
$47.46
|
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: Aetna Commercial |
$67.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.02
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$63.80
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$68.58
|
| Rate for Payer: Cofinity Commercial |
$39.08
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Cofinity Commercial |
$55.82
|
| Rate for Payer: Cofinity Commercial |
$61.41
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Healthscope Commercial |
$71.78
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.46
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: PHP Commercial |
$67.79
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.41
|
| Rate for Payer: Priority Health SBD |
$35.17
|
| Rate for Payer: Priority Health SBD |
$50.24
|
| Rate for Payer: Priority Health SBD |
$55.27
|
|
|
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$23.68
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
117869
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.03 |
| Max. Negotiated Rate |
$21.31 |
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: Aetna Commercial |
$52.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.39
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS Complete |
$9.47
|
| Rate for Payer: BCBS Trust/PPO |
$2.03
|
| Rate for Payer: BCBS Trust/PPO |
$2.03
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cash Price |
$48.95
|
| Rate for Payer: Cash Price |
$48.95
|
| Rate for Payer: Cofinity Commercial |
$42.83
|
| Rate for Payer: Cofinity Commercial |
$16.58
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$52.62
|
| Rate for Payer: Healthscope Commercial |
$55.07
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.13
|
| Rate for Payer: PHP Commercial |
$52.01
|
| Rate for Payer: PHP Commercial |
$20.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.83
|
| Rate for Payer: Priority Health SBD |
$14.92
|
| Rate for Payer: Priority Health SBD |
$38.55
|
|
|
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$23.68
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
117869
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.92 |
| Max. Negotiated Rate |
$21.31 |
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: Aetna Commercial |
$52.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.77
|
| Rate for Payer: Cash Price |
$48.95
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cofinity Commercial |
$52.62
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$16.58
|
| Rate for Payer: Cofinity Commercial |
$42.83
|
| Rate for Payer: Healthscope Commercial |
$55.07
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.13
|
| Rate for Payer: PHP Commercial |
$20.13
|
| Rate for Payer: PHP Commercial |
$52.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.83
|
| Rate for Payer: Priority Health SBD |
$38.55
|
| Rate for Payer: Priority Health SBD |
$14.92
|
|
|
MAGNESIUM SULFATE 4.06 MEQ/ML (50 %) INJECTION (TPN COMPONENT)
|
Facility
|
IP
|
$93.00
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
180902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$58.59 |
| Max. Negotiated Rate |
$83.70 |
| Rate for Payer: Aetna Commercial |
$79.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.45
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cofinity Commercial |
$65.10
|
| Rate for Payer: Cofinity Commercial |
$79.98
|
| Rate for Payer: Healthscope Commercial |
$83.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.05
|
| Rate for Payer: PHP Commercial |
$79.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.10
|
| Rate for Payer: Priority Health SBD |
$58.59
|
|
|
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$152.02
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
4719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$95.77 |
| Max. Negotiated Rate |
$136.82 |
| Rate for Payer: Aetna Commercial |
$129.22
|
| Rate for Payer: Aetna Commercial |
$217.32
|
| Rate for Payer: Aetna Commercial |
$199.70
|
| Rate for Payer: Aetna Commercial |
$399.40
|
| Rate for Payer: Aetna Commercial |
$205.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.19
|
| Rate for Payer: Cash Price |
$121.62
|
| Rate for Payer: Cash Price |
$204.54
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cash Price |
$187.95
|
| Rate for Payer: Cash Price |
$193.48
|
| Rate for Payer: Cofinity Commercial |
$130.74
|
| Rate for Payer: Cofinity Commercial |
$404.10
|
| Rate for Payer: Cofinity Commercial |
$328.92
|
| Rate for Payer: Cofinity Commercial |
$164.46
|
| Rate for Payer: Cofinity Commercial |
$202.05
|
| Rate for Payer: Cofinity Commercial |
$219.88
|
| Rate for Payer: Cofinity Commercial |
$178.97
|
| Rate for Payer: Cofinity Commercial |
$169.30
|
| Rate for Payer: Cofinity Commercial |
$207.99
|
| Rate for Payer: Cofinity Commercial |
$106.41
|
| Rate for Payer: Healthscope Commercial |
$217.66
|
| Rate for Payer: Healthscope Commercial |
$230.10
|
| Rate for Payer: Healthscope Commercial |
$211.45
|
| Rate for Payer: Healthscope Commercial |
$422.89
|
| Rate for Payer: Healthscope Commercial |
$136.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$129.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$217.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$399.40
|
| Rate for Payer: PHP Commercial |
$129.22
|
| Rate for Payer: PHP Commercial |
$217.32
|
| Rate for Payer: PHP Commercial |
$199.70
|
| Rate for Payer: PHP Commercial |
$205.57
|
| Rate for Payer: PHP Commercial |
$399.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.92
|
| Rate for Payer: Priority Health SBD |
$148.01
|
| Rate for Payer: Priority Health SBD |
$161.07
|
| Rate for Payer: Priority Health SBD |
$296.02
|
| Rate for Payer: Priority Health SBD |
$95.77
|
| Rate for Payer: Priority Health SBD |
$152.37
|
|
|
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$469.88
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
4719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.03 |
| Max. Negotiated Rate |
$422.89 |
| Rate for Payer: Aetna Commercial |
$399.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.42
|
| Rate for Payer: BCBS Complete |
$187.95
|
| Rate for Payer: BCBS Trust/PPO |
$2.03
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cofinity Commercial |
$328.92
|
| Rate for Payer: Cofinity Commercial |
$404.10
|
| Rate for Payer: Healthscope Commercial |
$422.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$399.40
|
| Rate for Payer: PHP Commercial |
$399.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.92
|
| Rate for Payer: Priority Health SBD |
$296.02
|
|
|
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION
|
Facility
|
OP
|
$21.44
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
4720
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.03 |
| Max. Negotiated Rate |
$19.30 |
| Rate for Payer: Aetna Commercial |
$18.22
|
| Rate for Payer: Aetna Commercial |
$18.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.94
|
| Rate for Payer: BCBS Complete |
$8.58
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: BCBS Trust/PPO |
$2.03
|
| Rate for Payer: BCBS Trust/PPO |
$2.03
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$17.80
|
| Rate for Payer: Cash Price |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$15.01
|
| Rate for Payer: Cofinity Commercial |
$15.58
|
| Rate for Payer: Cofinity Commercial |
$19.14
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$19.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.91
|
| Rate for Payer: PHP Commercial |
$18.91
|
| Rate for Payer: PHP Commercial |
$18.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.58
|
| Rate for Payer: Priority Health SBD |
$13.51
|
| Rate for Payer: Priority Health SBD |
$14.02
|
|
|
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION
|
Facility
|
IP
|
$15.37
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
4720
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$13.83 |
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: Aetna Commercial |
$18.22
|
| Rate for Payer: Aetna Commercial |
$47.47
|
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: Aetna Commercial |
$18.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.99
|
| Rate for Payer: Cash Price |
$17.80
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$44.68
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Cofinity Commercial |
$10.76
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$15.01
|
| Rate for Payer: Cofinity Commercial |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$15.58
|
| Rate for Payer: Cofinity Commercial |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$19.39
|
| Rate for Payer: Cofinity Commercial |
$39.10
|
| Rate for Payer: Cofinity Commercial |
$48.03
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$19.30
|
| Rate for Payer: Healthscope Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$13.83
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.91
|
| Rate for Payer: PHP Commercial |
$47.47
|
| Rate for Payer: PHP Commercial |
$18.22
|
| Rate for Payer: PHP Commercial |
$13.06
|
| Rate for Payer: PHP Commercial |
$23.54
|
| Rate for Payer: PHP Commercial |
$18.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.39
|
| Rate for Payer: Priority Health SBD |
$9.68
|
| Rate for Payer: Priority Health SBD |
$13.51
|
| Rate for Payer: Priority Health SBD |
$14.02
|
| Rate for Payer: Priority Health SBD |
$17.45
|
| Rate for Payer: Priority Health SBD |
$35.19
|
|
|
MAJOR BLADDER PROCEDURES WITH CC
|
Facility
|
IP
|
$58,035.44
|
|
|
Service Code
|
MS-DRG 654
|
| Min. Negotiated Rate |
$19,197.25 |
| Max. Negotiated Rate |
$58,035.44 |
| Rate for Payer: Aetna Medicare |
$21,015.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,259.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,259.54
|
| Rate for Payer: BCBS MAPPO |
$20,207.63
|
| Rate for Payer: BCBS Trust/PPO |
$58,035.44
|
| Rate for Payer: BCN Medicare Advantage |
$20,207.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,207.63
|
| Rate for Payer: Mclaren Medicare |
$20,207.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21,218.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,238.77
|
| Rate for Payer: PACE Medicare |
$19,197.25
|
| Rate for Payer: PACE SWMI |
$20,207.63
|
| Rate for Payer: PHP Medicare Advantage |
$20,207.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,282.91
|
| Rate for Payer: Priority Health Medicare |
$20,207.63
|
| Rate for Payer: Priority Health Narrow Network |
$31,426.33
|
| Rate for Payer: Railroad Medicare Medicare |
$20,207.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41,757.83
|
| Rate for Payer: UHC Core |
$25,623.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,207.63
|
| Rate for Payer: UHC Exchange |
$27,443.44
|
| Rate for Payer: UHC Medicare Advantage |
$20,813.86
|
| Rate for Payer: VA VA |
$20,207.63
|
|
|
MAJOR BLADDER PROCEDURES WITH MCC
|
Facility
|
IP
|
$82,579.05
|
|
|
Service Code
|
MS-DRG 653
|
| Min. Negotiated Rate |
$37,506.33 |
| Max. Negotiated Rate |
$82,579.05 |
| Rate for Payer: Aetna Medicare |
$41,059.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49,350.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49,350.44
|
| Rate for Payer: BCBS MAPPO |
$39,480.35
|
| Rate for Payer: BCBS Trust/PPO |
$58,088.14
|
| Rate for Payer: BCN Medicare Advantage |
$39,480.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39,480.35
|
| Rate for Payer: Mclaren Medicare |
$39,480.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41,454.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45,402.40
|
| Rate for Payer: PACE Medicare |
$37,506.33
|
| Rate for Payer: PACE SWMI |
$39,480.35
|
| Rate for Payer: PHP Medicare Advantage |
$39,480.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77,684.73
|
| Rate for Payer: Priority Health Medicare |
$39,480.35
|
| Rate for Payer: Priority Health Narrow Network |
$62,147.78
|
| Rate for Payer: Railroad Medicare Medicare |
$39,480.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82,579.05
|
| Rate for Payer: UHC Core |
$50,671.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$39,480.35
|
| Rate for Payer: UHC Exchange |
$54,271.34
|
| Rate for Payer: UHC Medicare Advantage |
$40,664.76
|
| Rate for Payer: VA VA |
$39,480.35
|
|
|
MAJOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$51,640.98
|
|
|
Service Code
|
MS-DRG 655
|
| Min. Negotiated Rate |
$14,889.04 |
| Max. Negotiated Rate |
$51,640.98 |
| Rate for Payer: Aetna Medicare |
$16,299.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,590.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,590.84
|
| Rate for Payer: BCBS MAPPO |
$15,672.67
|
| Rate for Payer: BCBS Trust/PPO |
$51,640.98
|
| Rate for Payer: BCN Medicare Advantage |
$15,672.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,672.67
|
| Rate for Payer: Mclaren Medicare |
$15,672.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,456.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,023.57
|
| Rate for Payer: PACE Medicare |
$14,889.04
|
| Rate for Payer: PACE SWMI |
$15,672.67
|
| Rate for Payer: PHP Medicare Advantage |
$15,672.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,246.76
|
| Rate for Payer: Priority Health Medicare |
$15,672.67
|
| Rate for Payer: Priority Health Narrow Network |
$24,197.41
|
| Rate for Payer: Railroad Medicare Medicare |
$15,672.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,152.38
|
| Rate for Payer: UHC Core |
$19,729.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,672.67
|
| Rate for Payer: UHC Exchange |
$21,130.70
|
| Rate for Payer: UHC Medicare Advantage |
$16,142.85
|
| Rate for Payer: VA VA |
$15,672.67
|
|
|
MAJOR CHEST PROCEDURES WITH CC
|
Facility
|
IP
|
$44,554.81
|
|
|
Service Code
|
MS-DRG 164
|
| Min. Negotiated Rate |
$17,917.18 |
| Max. Negotiated Rate |
$44,554.81 |
| Rate for Payer: Aetna Medicare |
$19,614.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,575.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,575.24
|
| Rate for Payer: BCBS MAPPO |
$18,860.19
|
| Rate for Payer: BCBS Trust/PPO |
$44,554.81
|
| Rate for Payer: BCN Medicare Advantage |
$18,860.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,860.19
|
| Rate for Payer: Mclaren Medicare |
$18,860.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19,803.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,689.22
|
| Rate for Payer: PACE Medicare |
$17,917.18
|
| Rate for Payer: PACE SWMI |
$18,860.19
|
| Rate for Payer: PHP Medicare Advantage |
$18,860.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36,598.04
|
| Rate for Payer: Priority Health Medicare |
$18,860.19
|
| Rate for Payer: Priority Health Narrow Network |
$29,278.43
|
| Rate for Payer: Railroad Medicare Medicare |
$18,860.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38,903.80
|
| Rate for Payer: UHC Core |
$23,871.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,860.19
|
| Rate for Payer: UHC Exchange |
$25,567.76
|
| Rate for Payer: UHC Medicare Advantage |
$19,426.00
|
| Rate for Payer: VA VA |
$18,860.19
|
|
|
MAJOR CHEST PROCEDURES WITH MCC
|
Facility
|
IP
|
$71,901.25
|
|
|
Service Code
|
MS-DRG 163
|
| Min. Negotiated Rate |
$32,717.14 |
| Max. Negotiated Rate |
$71,901.25 |
| Rate for Payer: Aetna Medicare |
$35,816.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43,048.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43,048.88
|
| Rate for Payer: BCBS MAPPO |
$34,439.10
|
| Rate for Payer: BCBS Trust/PPO |
$63,694.28
|
| Rate for Payer: BCN Medicare Advantage |
$34,439.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34,439.10
|
| Rate for Payer: Mclaren Medicare |
$34,439.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36,161.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39,604.96
|
| Rate for Payer: PACE Medicare |
$32,717.14
|
| Rate for Payer: PACE SWMI |
$34,439.10
|
| Rate for Payer: PHP Medicare Advantage |
$34,439.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67,639.78
|
| Rate for Payer: Priority Health Medicare |
$34,439.10
|
| Rate for Payer: Priority Health Narrow Network |
$54,111.82
|
| Rate for Payer: Railroad Medicare Medicare |
$34,439.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71,901.25
|
| Rate for Payer: UHC Core |
$44,119.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$34,439.10
|
| Rate for Payer: UHC Exchange |
$47,253.84
|
| Rate for Payer: UHC Medicare Advantage |
$35,472.27
|
| Rate for Payer: VA VA |
$34,439.10
|
|
|
MAJOR CHEST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$35,630.67
|
|
|
Service Code
|
MS-DRG 165
|
| Min. Negotiated Rate |
$13,305.87 |
| Max. Negotiated Rate |
$35,630.67 |
| Rate for Payer: Aetna Medicare |
$14,566.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,507.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,507.72
|
| Rate for Payer: BCBS MAPPO |
$14,006.18
|
| Rate for Payer: BCBS Trust/PPO |
$35,630.67
|
| Rate for Payer: BCN Medicare Advantage |
$14,006.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,006.18
|
| Rate for Payer: Mclaren Medicare |
$14,006.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,706.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,107.11
|
| Rate for Payer: PACE Medicare |
$13,305.87
|
| Rate for Payer: PACE SWMI |
$14,006.18
|
| Rate for Payer: PHP Medicare Advantage |
$14,006.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,926.19
|
| Rate for Payer: Priority Health Medicare |
$14,006.18
|
| Rate for Payer: Priority Health Narrow Network |
$21,540.95
|
| Rate for Payer: Railroad Medicare Medicare |
$14,006.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,622.61
|
| Rate for Payer: UHC Core |
$17,563.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,006.18
|
| Rate for Payer: UHC Exchange |
$18,810.91
|
| Rate for Payer: UHC Medicare Advantage |
$14,426.37
|
| Rate for Payer: VA VA |
$14,006.18
|
|
|
MAJOR CHEST TRAUMA WITH CC
|
Facility
|
IP
|
$16,974.31
|
|
|
Service Code
|
MS-DRG 184
|
| Min. Negotiated Rate |
$7,664.88 |
| Max. Negotiated Rate |
$16,974.31 |
| Rate for Payer: Aetna Medicare |
$8,391.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,085.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,085.38
|
| Rate for Payer: BCBS MAPPO |
$8,068.30
|
| Rate for Payer: BCBS Trust/PPO |
$16,974.31
|
| Rate for Payer: BCN Medicare Advantage |
$8,068.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,068.30
|
| Rate for Payer: Mclaren Medicare |
$8,068.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,471.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,278.54
|
| Rate for Payer: PACE Medicare |
$7,664.88
|
| Rate for Payer: PACE SWMI |
$8,068.30
|
| Rate for Payer: PHP Medicare Advantage |
$8,068.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,094.68
|
| Rate for Payer: Priority Health Medicare |
$8,068.30
|
| Rate for Payer: Priority Health Narrow Network |
$12,075.74
|
| Rate for Payer: Railroad Medicare Medicare |
$8,068.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,045.68
|
| Rate for Payer: UHC Core |
$9,845.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,068.30
|
| Rate for Payer: UHC Exchange |
$10,545.30
|
| Rate for Payer: UHC Medicare Advantage |
$8,310.35
|
| Rate for Payer: VA VA |
$8,068.30
|
|
|
MAJOR CHEST TRAUMA WITH MCC
|
Facility
|
IP
|
$24,017.42
|
|
|
Service Code
|
MS-DRG 183
|
| Min. Negotiated Rate |
$11,240.36 |
| Max. Negotiated Rate |
$24,017.42 |
| Rate for Payer: Aetna Medicare |
$12,305.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,789.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,789.95
|
| Rate for Payer: BCBS MAPPO |
$11,831.96
|
| Rate for Payer: BCBS Trust/PPO |
$19,503.98
|
| Rate for Payer: BCN Medicare Advantage |
$11,831.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,831.96
|
| Rate for Payer: Mclaren Medicare |
$11,831.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,423.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,606.75
|
| Rate for Payer: PACE Medicare |
$11,240.36
|
| Rate for Payer: PACE SWMI |
$11,831.96
|
| Rate for Payer: PHP Medicare Advantage |
$11,831.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,593.95
|
| Rate for Payer: Priority Health Medicare |
$11,831.96
|
| Rate for Payer: Priority Health Narrow Network |
$18,075.16
|
| Rate for Payer: Railroad Medicare Medicare |
$11,831.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,017.42
|
| Rate for Payer: UHC Core |
$14,737.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,831.96
|
| Rate for Payer: UHC Exchange |
$15,784.36
|
| Rate for Payer: UHC Medicare Advantage |
$12,186.92
|
| Rate for Payer: VA VA |
$11,831.96
|
|
|
MAJOR CHEST TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$13,476.24
|
|
|
Service Code
|
MS-DRG 185
|
| Min. Negotiated Rate |
$5,638.36 |
| Max. Negotiated Rate |
$13,476.24 |
| Rate for Payer: Aetna Medicare |
$6,172.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,418.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,418.90
|
| Rate for Payer: BCBS MAPPO |
$5,935.12
|
| Rate for Payer: BCBS Trust/PPO |
$13,476.24
|
| Rate for Payer: BCN Medicare Advantage |
$5,935.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,935.12
|
| Rate for Payer: Mclaren Medicare |
$5,935.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,231.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,825.39
|
| Rate for Payer: PACE Medicare |
$5,638.36
|
| Rate for Payer: PACE SWMI |
$5,935.12
|
| Rate for Payer: PHP Medicare Advantage |
$5,935.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,844.23
|
| Rate for Payer: Priority Health Medicare |
$5,935.12
|
| Rate for Payer: Priority Health Narrow Network |
$8,675.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5,935.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,527.45
|
| Rate for Payer: UHC Core |
$7,073.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,935.12
|
| Rate for Payer: UHC Exchange |
$7,575.89
|
| Rate for Payer: UHC Medicare Advantage |
$6,113.17
|
| Rate for Payer: VA VA |
$5,935.12
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITH CC
|
Facility
|
IP
|
$18,423.60
|
|
|
Service Code
|
MS-DRG 369
|
| Min. Negotiated Rate |
$7,229.75 |
| Max. Negotiated Rate |
$18,423.60 |
| Rate for Payer: Aetna Medicare |
$7,914.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,512.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,512.82
|
| Rate for Payer: BCBS MAPPO |
$7,610.26
|
| Rate for Payer: BCBS Trust/PPO |
$18,423.60
|
| Rate for Payer: BCN Medicare Advantage |
$7,610.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,610.26
|
| Rate for Payer: Mclaren Medicare |
$7,610.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,990.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,751.80
|
| Rate for Payer: PACE Medicare |
$7,229.75
|
| Rate for Payer: PACE SWMI |
$7,610.26
|
| Rate for Payer: PHP Medicare Advantage |
$7,610.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,182.03
|
| Rate for Payer: Priority Health Medicare |
$7,610.26
|
| Rate for Payer: Priority Health Narrow Network |
$11,345.62
|
| Rate for Payer: Railroad Medicare Medicare |
$7,610.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,075.53
|
| Rate for Payer: UHC Core |
$9,250.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,610.26
|
| Rate for Payer: UHC Exchange |
$9,907.71
|
| Rate for Payer: UHC Medicare Advantage |
$7,838.57
|
| Rate for Payer: VA VA |
$7,610.26
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITH MCC
|
Facility
|
IP
|
$25,406.56
|
|
|
Service Code
|
MS-DRG 368
|
| Min. Negotiated Rate |
$11,770.59 |
| Max. Negotiated Rate |
$25,406.56 |
| Rate for Payer: Aetna Medicare |
$12,885.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,487.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,487.61
|
| Rate for Payer: BCBS MAPPO |
$12,390.09
|
| Rate for Payer: BCBS Trust/PPO |
$25,406.56
|
| Rate for Payer: BCN Medicare Advantage |
$12,390.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,390.09
|
| Rate for Payer: Mclaren Medicare |
$12,390.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,009.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,248.60
|
| Rate for Payer: PACE Medicare |
$11,770.59
|
| Rate for Payer: PACE SWMI |
$12,390.09
|
| Rate for Payer: PHP Medicare Advantage |
$12,390.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,706.07
|
| Rate for Payer: Priority Health Medicare |
$12,390.09
|
| Rate for Payer: Priority Health Narrow Network |
$18,964.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12,390.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,199.61
|
| Rate for Payer: UHC Core |
$15,462.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,390.09
|
| Rate for Payer: UHC Exchange |
$16,561.30
|
| Rate for Payer: UHC Medicare Advantage |
$12,761.79
|
| Rate for Payer: VA VA |
$12,390.09
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,685.71
|
|
|
Service Code
|
MS-DRG 370
|
| Min. Negotiated Rate |
$5,556.26 |
| Max. Negotiated Rate |
$12,685.71 |
| Rate for Payer: Aetna Medicare |
$6,082.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,310.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,310.88
|
| Rate for Payer: BCBS MAPPO |
$5,848.70
|
| Rate for Payer: BCBS Trust/PPO |
$12,685.71
|
| Rate for Payer: BCN Medicare Advantage |
$5,848.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,848.70
|
| Rate for Payer: Mclaren Medicare |
$5,848.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,141.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,726.00
|
| Rate for Payer: PACE Medicare |
$5,556.26
|
| Rate for Payer: PACE SWMI |
$5,848.70
|
| Rate for Payer: PHP Medicare Advantage |
$5,848.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,672.04
|
| Rate for Payer: Priority Health Medicare |
$5,848.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,537.63
|
| Rate for Payer: Railroad Medicare Medicare |
$5,848.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,344.40
|
| Rate for Payer: UHC Core |
$6,961.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,848.70
|
| Rate for Payer: UHC Exchange |
$7,455.59
|
| Rate for Payer: UHC Medicare Advantage |
$6,024.16
|
| Rate for Payer: VA VA |
$5,848.70
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC
|
Facility
|
IP
|
$15,899.24
|
|
|
Service Code
|
MS-DRG 372
|
| Min. Negotiated Rate |
$7,599.22 |
| Max. Negotiated Rate |
$15,899.24 |
| Rate for Payer: Aetna Medicare |
$8,319.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,998.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,998.98
|
| Rate for Payer: BCBS MAPPO |
$7,999.18
|
| Rate for Payer: BCBS Trust/PPO |
$14,886.01
|
| Rate for Payer: BCN Medicare Advantage |
$7,999.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,999.18
|
| Rate for Payer: Mclaren Medicare |
$7,999.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,399.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,199.06
|
| Rate for Payer: PACE Medicare |
$7,599.22
|
| Rate for Payer: PACE SWMI |
$7,999.18
|
| Rate for Payer: PHP Medicare Advantage |
$7,999.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,956.92
|
| Rate for Payer: Priority Health Medicare |
$7,999.18
|
| Rate for Payer: Priority Health Narrow Network |
$11,965.54
|
| Rate for Payer: Railroad Medicare Medicare |
$7,999.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,899.24
|
| Rate for Payer: UHC Core |
$9,755.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,999.18
|
| Rate for Payer: UHC Exchange |
$10,449.06
|
| Rate for Payer: UHC Medicare Advantage |
$8,239.16
|
| Rate for Payer: VA VA |
$7,999.18
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC
|
Facility
|
IP
|
$28,671.87
|
|
|
Service Code
|
MS-DRG 371
|
| Min. Negotiated Rate |
$12,425.35 |
| Max. Negotiated Rate |
$28,671.87 |
| Rate for Payer: Aetna Medicare |
$13,602.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,349.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,349.15
|
| Rate for Payer: BCBS MAPPO |
$13,079.32
|
| Rate for Payer: BCBS Trust/PPO |
$28,671.87
|
| Rate for Payer: BCN Medicare Advantage |
$13,079.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,079.32
|
| Rate for Payer: Mclaren Medicare |
$13,079.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,733.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,041.22
|
| Rate for Payer: PACE Medicare |
$12,425.35
|
| Rate for Payer: PACE SWMI |
$13,079.32
|
| Rate for Payer: PHP Medicare Advantage |
$13,079.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,079.36
|
| Rate for Payer: Priority Health Medicare |
$13,079.32
|
| Rate for Payer: Priority Health Narrow Network |
$20,063.49
|
| Rate for Payer: Railroad Medicare Medicare |
$13,079.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,659.42
|
| Rate for Payer: UHC Core |
$16,358.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,079.32
|
| Rate for Payer: UHC Exchange |
$17,520.69
|
| Rate for Payer: UHC Medicare Advantage |
$13,471.70
|
| Rate for Payer: VA VA |
$13,079.32
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,824.06
|
|
|
Service Code
|
MS-DRG 373
|
| Min. Negotiated Rate |
$5,370.17 |
| Max. Negotiated Rate |
$12,824.06 |
| Rate for Payer: Aetna Medicare |
$5,878.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,066.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,066.01
|
| Rate for Payer: BCBS MAPPO |
$5,652.81
|
| Rate for Payer: BCBS Trust/PPO |
$12,824.06
|
| Rate for Payer: BCN Medicare Advantage |
$5,652.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,652.81
|
| Rate for Payer: Mclaren Medicare |
$5,652.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,935.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,500.73
|
| Rate for Payer: PACE Medicare |
$5,370.17
|
| Rate for Payer: PACE SWMI |
$5,652.81
|
| Rate for Payer: PHP Medicare Advantage |
$5,652.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,281.72
|
| Rate for Payer: Priority Health Medicare |
$5,652.81
|
| Rate for Payer: Priority Health Narrow Network |
$8,225.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5,652.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,929.49
|
| Rate for Payer: UHC Core |
$6,706.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,652.81
|
| Rate for Payer: UHC Exchange |
$7,182.91
|
| Rate for Payer: UHC Medicare Advantage |
$5,822.39
|
| Rate for Payer: VA VA |
$5,652.81
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$56,166.73
|
|
|
Service Code
|
MS-DRG 141
|
| Min. Negotiated Rate |
$14,642.06 |
| Max. Negotiated Rate |
$56,166.73 |
| Rate for Payer: Aetna Medicare |
$16,029.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,265.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,265.86
|
| Rate for Payer: BCBS MAPPO |
$15,412.69
|
| Rate for Payer: BCBS Trust/PPO |
$56,166.73
|
| Rate for Payer: BCN Medicare Advantage |
$15,412.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,412.69
|
| Rate for Payer: Mclaren Medicare |
$15,412.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,183.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,724.59
|
| Rate for Payer: PACE Medicare |
$14,642.06
|
| Rate for Payer: PACE SWMI |
$15,412.69
|
| Rate for Payer: PHP Medicare Advantage |
$15,412.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29,728.73
|
| Rate for Payer: Priority Health Medicare |
$15,412.69
|
| Rate for Payer: Priority Health Narrow Network |
$23,782.98
|
| Rate for Payer: Railroad Medicare Medicare |
$15,412.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,601.71
|
| Rate for Payer: UHC Core |
$19,391.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,412.69
|
| Rate for Payer: UHC Exchange |
$20,768.79
|
| Rate for Payer: UHC Medicare Advantage |
$15,875.07
|
| Rate for Payer: VA VA |
$15,412.69
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$73,589.00
|
|
|
Service Code
|
MS-DRG 140
|
| Min. Negotiated Rate |
$26,316.72 |
| Max. Negotiated Rate |
$73,589.00 |
| Rate for Payer: Aetna Medicare |
$28,809.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,627.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,627.26
|
| Rate for Payer: BCBS MAPPO |
$27,701.81
|
| Rate for Payer: BCBS Trust/PPO |
$73,589.00
|
| Rate for Payer: BCN Medicare Advantage |
$27,701.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,701.81
|
| Rate for Payer: Mclaren Medicare |
$27,701.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29,086.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,857.08
|
| Rate for Payer: PACE Medicare |
$26,316.72
|
| Rate for Payer: PACE SWMI |
$27,701.81
|
| Rate for Payer: PHP Medicare Advantage |
$27,701.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54,215.43
|
| Rate for Payer: Priority Health Medicare |
$27,701.81
|
| Rate for Payer: Priority Health Narrow Network |
$43,372.34
|
| Rate for Payer: Railroad Medicare Medicare |
$27,701.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57,631.14
|
| Rate for Payer: UHC Core |
$35,363.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,701.81
|
| Rate for Payer: UHC Exchange |
$37,875.45
|
| Rate for Payer: UHC Medicare Advantage |
$28,532.86
|
| Rate for Payer: VA VA |
$27,701.81
|
|
