|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
|
IP
|
$8,334.06
|
|
|
Service Code
|
APR-DRG 1922
|
| Min. Negotiated Rate |
$7,937.20 |
| Max. Negotiated Rate |
$8,334.06 |
| Rate for Payer: BCBS Complete |
$8,334.06
|
| Rate for Payer: Mclaren Medicaid |
$7,937.20
|
| Rate for Payer: Meridian Medicaid |
$8,334.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,937.20
|
| Rate for Payer: UHC Medicaid |
$7,937.20
|
| Rate for Payer: UHCCP Medicaid |
$7,937.20
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
|
IP
|
$6,586.07
|
|
|
Service Code
|
APR-DRG 1921
|
| Min. Negotiated Rate |
$6,272.45 |
| Max. Negotiated Rate |
$6,586.07 |
| Rate for Payer: BCBS Complete |
$6,586.07
|
| Rate for Payer: Mclaren Medicaid |
$6,272.45
|
| Rate for Payer: Meridian Medicaid |
$6,586.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,272.45
|
| Rate for Payer: UHC Medicaid |
$6,272.45
|
| Rate for Payer: UHCCP Medicaid |
$6,272.45
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
|
IP
|
$17,667.39
|
|
|
Service Code
|
APR-DRG 1924
|
| Min. Negotiated Rate |
$16,826.08 |
| Max. Negotiated Rate |
$17,667.39 |
| Rate for Payer: BCBS Complete |
$17,667.39
|
| Rate for Payer: Mclaren Medicaid |
$16,826.08
|
| Rate for Payer: Meridian Medicaid |
$17,667.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,826.08
|
| Rate for Payer: UHC Medicaid |
$16,826.08
|
| Rate for Payer: UHCCP Medicaid |
$16,826.08
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$36,261.33
|
|
|
Service Code
|
MSDRG 306
|
| Min. Negotiated Rate |
$12,119.28 |
| Max. Negotiated Rate |
$36,261.33 |
| Rate for Payer: Aetna Medicare |
$13,267.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,946.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,946.42
|
| Rate for Payer: BCBS MAPPO |
$12,757.14
|
| Rate for Payer: BCBS Trust/PPO |
$36,261.33
|
| Rate for Payer: BCN Commercial |
$36,261.33
|
| Rate for Payer: BCN Medicare Advantage |
$12,757.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,757.14
|
| Rate for Payer: Mclaren Medicare |
$12,757.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,395.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,670.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,032.85
|
| Rate for Payer: Nomi Health Commercial |
$20,327.82
|
| Rate for Payer: PACE Medicare |
$12,119.28
|
| Rate for Payer: PACE SWMI |
$12,757.14
|
| Rate for Payer: PHP Medicare Advantage |
$12,757.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,405.27
|
| Rate for Payer: Priority Health Medicare |
$12,757.14
|
| Rate for Payer: Priority Health Tiered Network |
$20,324.21
|
| Rate for Payer: Railroad Medicare Medicare |
$12,757.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,685.54
|
| Rate for Payer: UHC Core |
$21,489.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,757.14
|
| Rate for Payer: UHC Exchange |
$17,549.68
|
| Rate for Payer: VA VA |
$12,757.14
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$19,721.24
|
|
|
Service Code
|
MSDRG 307
|
| Min. Negotiated Rate |
$7,254.60 |
| Max. Negotiated Rate |
$19,721.24 |
| Rate for Payer: Aetna Medicare |
$7,941.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,545.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,545.52
|
| Rate for Payer: BCBS MAPPO |
$7,636.42
|
| Rate for Payer: BCBS Trust/PPO |
$19,721.24
|
| Rate for Payer: BCN Commercial |
$19,721.24
|
| Rate for Payer: BCN Medicare Advantage |
$7,636.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,636.42
|
| Rate for Payer: Mclaren Medicare |
$7,636.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,018.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,781.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,400.06
|
| Rate for Payer: Nomi Health Commercial |
$11,780.28
|
| Rate for Payer: PACE Medicare |
$7,254.60
|
| Rate for Payer: PACE SWMI |
$7,636.42
|
| Rate for Payer: PHP Medicare Advantage |
$7,636.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14,722.74
|
| Rate for Payer: Priority Health Medicare |
$7,636.42
|
| Rate for Payer: Priority Health Tiered Network |
$11,778.19
|
| Rate for Payer: Railroad Medicare Medicare |
$7,636.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,885.16
|
| Rate for Payer: UHC Core |
$12,453.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,636.42
|
| Rate for Payer: UHC Exchange |
$10,170.31
|
| Rate for Payer: VA VA |
$7,636.42
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
|
IP
|
$140,902.12
|
|
|
Service Code
|
MSDRG 275
|
| Min. Negotiated Rate |
$52,900.14 |
| Max. Negotiated Rate |
$140,902.12 |
| Rate for Payer: Aetna Medicare |
$57,911.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69,605.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69,605.45
|
| Rate for Payer: BCBS MAPPO |
$55,684.36
|
| Rate for Payer: BCBS Trust/PPO |
$140,902.12
|
| Rate for Payer: BCN Commercial |
$140,902.12
|
| Rate for Payer: BCN Medicare Advantage |
$55,684.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55,684.36
|
| Rate for Payer: Mclaren Medicare |
$55,684.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58,468.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64,037.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$61,252.80
|
| Rate for Payer: Nomi Health Commercial |
$91,982.16
|
| Rate for Payer: PACE Medicare |
$52,900.14
|
| Rate for Payer: PACE SWMI |
$55,684.36
|
| Rate for Payer: PHP Medicare Advantage |
$55,684.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$114,957.31
|
| Rate for Payer: Priority Health Medicare |
$55,684.36
|
| Rate for Payer: Priority Health Tiered Network |
$91,965.83
|
| Rate for Payer: Railroad Medicare Medicare |
$55,684.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116,225.52
|
| Rate for Payer: UHC Core |
$97,237.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55,684.36
|
| Rate for Payer: UHC Exchange |
$79,411.26
|
| Rate for Payer: VA VA |
$55,684.36
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR
|
Facility
|
IP
|
$136,307.12
|
|
|
Service Code
|
MSDRG 276
|
| Min. Negotiated Rate |
$44,649.40 |
| Max. Negotiated Rate |
$136,307.12 |
| Rate for Payer: Aetna Medicare |
$48,879.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58,749.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58,749.21
|
| Rate for Payer: BCBS MAPPO |
$46,999.37
|
| Rate for Payer: BCBS Trust/PPO |
$136,307.12
|
| Rate for Payer: BCN Commercial |
$136,307.12
|
| Rate for Payer: BCN Medicare Advantage |
$46,999.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,999.37
|
| Rate for Payer: Mclaren Medicare |
$46,999.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49,349.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54,049.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$51,699.31
|
| Rate for Payer: Nomi Health Commercial |
$77,485.14
|
| Rate for Payer: PACE Medicare |
$44,649.40
|
| Rate for Payer: PACE SWMI |
$46,999.37
|
| Rate for Payer: PHP Medicare Advantage |
$46,999.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$96,839.25
|
| Rate for Payer: Priority Health Medicare |
$46,999.37
|
| Rate for Payer: Priority Health Tiered Network |
$77,471.38
|
| Rate for Payer: Railroad Medicare Medicare |
$46,999.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97,907.58
|
| Rate for Payer: UHC Core |
$81,912.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46,999.37
|
| Rate for Payer: UHC Exchange |
$66,895.50
|
| Rate for Payer: VA VA |
$46,999.37
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
|
IP
|
$105,909.50
|
|
|
Service Code
|
MSDRG 277
|
| Min. Negotiated Rate |
$34,458.23 |
| Max. Negotiated Rate |
$105,909.50 |
| Rate for Payer: Aetna Medicare |
$37,722.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,339.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,339.78
|
| Rate for Payer: BCBS MAPPO |
$36,271.82
|
| Rate for Payer: BCBS Trust/PPO |
$105,909.50
|
| Rate for Payer: BCN Commercial |
$105,909.50
|
| Rate for Payer: BCN Medicare Advantage |
$36,271.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,271.82
|
| Rate for Payer: Mclaren Medicare |
$36,271.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,085.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41,712.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$39,899.00
|
| Rate for Payer: Nomi Health Commercial |
$59,578.65
|
| Rate for Payer: PACE Medicare |
$34,458.23
|
| Rate for Payer: PACE SWMI |
$36,271.82
|
| Rate for Payer: PHP Medicare Advantage |
$36,271.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$74,460.10
|
| Rate for Payer: Priority Health Medicare |
$36,271.82
|
| Rate for Payer: Priority Health Tiered Network |
$59,568.07
|
| Rate for Payer: Railroad Medicare Medicare |
$36,271.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75,281.55
|
| Rate for Payer: UHC Core |
$62,982.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36,271.82
|
| Rate for Payer: UHC Exchange |
$51,436.23
|
| Rate for Payer: VA VA |
$36,271.82
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$18,668.94
|
|
|
Service Code
|
APR-DRG 1773
|
| Min. Negotiated Rate |
$17,779.94 |
| Max. Negotiated Rate |
$18,668.94 |
| Rate for Payer: BCBS Complete |
$18,668.94
|
| Rate for Payer: Mclaren Medicaid |
$17,779.94
|
| Rate for Payer: Meridian Medicaid |
$18,668.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,779.94
|
| Rate for Payer: UHC Medicaid |
$17,779.94
|
| Rate for Payer: UHCCP Medicaid |
$17,779.94
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$12,892.37
|
|
|
Service Code
|
APR-DRG 1772
|
| Min. Negotiated Rate |
$12,278.45 |
| Max. Negotiated Rate |
$12,892.37 |
| Rate for Payer: BCBS Complete |
$12,892.37
|
| Rate for Payer: Mclaren Medicaid |
$12,278.45
|
| Rate for Payer: Meridian Medicaid |
$12,892.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,278.45
|
| Rate for Payer: UHC Medicaid |
$12,278.45
|
| Rate for Payer: UHCCP Medicaid |
$12,278.45
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$8,769.20
|
|
|
Service Code
|
APR-DRG 1771
|
| Min. Negotiated Rate |
$8,351.62 |
| Max. Negotiated Rate |
$8,769.20 |
| Rate for Payer: BCBS Complete |
$8,769.20
|
| Rate for Payer: Mclaren Medicaid |
$8,351.62
|
| Rate for Payer: Meridian Medicaid |
$8,769.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,351.62
|
| Rate for Payer: UHC Medicaid |
$8,351.62
|
| Rate for Payer: UHCCP Medicaid |
$8,351.62
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$22,509.48
|
|
|
Service Code
|
APR-DRG 1774
|
| Min. Negotiated Rate |
$21,437.60 |
| Max. Negotiated Rate |
$22,509.48 |
| Rate for Payer: BCBS Complete |
$22,509.48
|
| Rate for Payer: Mclaren Medicaid |
$21,437.60
|
| Rate for Payer: Meridian Medicaid |
$22,509.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,437.60
|
| Rate for Payer: UHC Medicaid |
$21,437.60
|
| Rate for Payer: UHCCP Medicaid |
$21,437.60
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$51,216.23
|
|
|
Service Code
|
MSDRG 258
|
| Min. Negotiated Rate |
$23,618.78 |
| Max. Negotiated Rate |
$51,216.23 |
| Rate for Payer: Aetna Medicare |
$25,856.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,077.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,077.34
|
| Rate for Payer: BCBS MAPPO |
$24,861.87
|
| Rate for Payer: BCBS Trust/PPO |
$48,007.47
|
| Rate for Payer: BCN Commercial |
$48,007.47
|
| Rate for Payer: BCN Medicare Advantage |
$24,861.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,861.87
|
| Rate for Payer: Mclaren Medicare |
$24,861.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,104.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,591.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$27,348.06
|
| Rate for Payer: Nomi Health Commercial |
$40,533.09
|
| Rate for Payer: PACE Medicare |
$23,618.78
|
| Rate for Payer: PACE SWMI |
$24,861.87
|
| Rate for Payer: PHP Medicare Advantage |
$24,861.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50,657.38
|
| Rate for Payer: Priority Health Medicare |
$24,861.87
|
| Rate for Payer: Priority Health Tiered Network |
$40,525.89
|
| Rate for Payer: Railroad Medicare Medicare |
$24,861.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51,216.23
|
| Rate for Payer: UHC Core |
$42,848.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24,861.87
|
| Rate for Payer: UHC Exchange |
$34,993.57
|
| Rate for Payer: VA VA |
$24,861.87
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
|
IP
|
$32,960.23
|
|
|
Service Code
|
MSDRG 259
|
| Min. Negotiated Rate |
$15,395.93 |
| Max. Negotiated Rate |
$32,960.23 |
| Rate for Payer: Aetna Medicare |
$16,854.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,257.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,257.80
|
| Rate for Payer: BCBS MAPPO |
$16,206.24
|
| Rate for Payer: BCBS Trust/PPO |
$30,896.22
|
| Rate for Payer: BCN Commercial |
$30,896.22
|
| Rate for Payer: BCN Medicare Advantage |
$16,206.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,206.24
|
| Rate for Payer: Mclaren Medicare |
$16,206.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,016.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,637.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,826.86
|
| Rate for Payer: Nomi Health Commercial |
$26,085.09
|
| Rate for Payer: PACE Medicare |
$15,395.93
|
| Rate for Payer: PACE SWMI |
$16,206.24
|
| Rate for Payer: PHP Medicare Advantage |
$16,206.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32,600.58
|
| Rate for Payer: Priority Health Medicare |
$16,206.24
|
| Rate for Payer: Priority Health Tiered Network |
$26,080.46
|
| Rate for Payer: Railroad Medicare Medicare |
$16,206.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,960.23
|
| Rate for Payer: UHC Core |
$27,575.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,206.24
|
| Rate for Payer: UHC Exchange |
$22,520.13
|
| Rate for Payer: VA VA |
$16,206.24
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
|
IP
|
$42,855.37
|
|
|
Service Code
|
MSDRG 261
|
| Min. Negotiated Rate |
$14,429.76 |
| Max. Negotiated Rate |
$42,855.37 |
| Rate for Payer: Aetna Medicare |
$15,796.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,986.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,986.53
|
| Rate for Payer: BCBS MAPPO |
$15,189.22
|
| Rate for Payer: BCBS Trust/PPO |
$42,855.37
|
| Rate for Payer: BCN Commercial |
$42,855.37
|
| Rate for Payer: BCN Medicare Advantage |
$15,189.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,189.22
|
| Rate for Payer: Mclaren Medicare |
$15,189.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,948.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,467.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,708.14
|
| Rate for Payer: Nomi Health Commercial |
$24,387.45
|
| Rate for Payer: PACE Medicare |
$14,429.76
|
| Rate for Payer: PACE SWMI |
$15,189.22
|
| Rate for Payer: PHP Medicare Advantage |
$15,189.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30,478.91
|
| Rate for Payer: Priority Health Medicare |
$15,189.22
|
| Rate for Payer: Priority Health Tiered Network |
$24,383.12
|
| Rate for Payer: Railroad Medicare Medicare |
$15,189.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,815.15
|
| Rate for Payer: UHC Core |
$25,780.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,189.22
|
| Rate for Payer: UHC Exchange |
$21,054.50
|
| Rate for Payer: VA VA |
$15,189.22
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$78,283.37
|
|
|
Service Code
|
MSDRG 260
|
| Min. Negotiated Rate |
$24,431.50 |
| Max. Negotiated Rate |
$78,283.37 |
| Rate for Payer: Aetna Medicare |
$26,746.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,146.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,146.71
|
| Rate for Payer: BCBS MAPPO |
$25,717.37
|
| Rate for Payer: BCBS Trust/PPO |
$78,283.37
|
| Rate for Payer: BCN Commercial |
$78,283.37
|
| Rate for Payer: BCN Medicare Advantage |
$25,717.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,717.37
|
| Rate for Payer: Mclaren Medicare |
$25,717.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,003.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,574.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,289.11
|
| Rate for Payer: Nomi Health Commercial |
$41,961.12
|
| Rate for Payer: PACE Medicare |
$24,431.50
|
| Rate for Payer: PACE SWMI |
$25,717.37
|
| Rate for Payer: PHP Medicare Advantage |
$25,717.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$52,442.10
|
| Rate for Payer: Priority Health Medicare |
$25,717.37
|
| Rate for Payer: Priority Health Tiered Network |
$41,953.67
|
| Rate for Payer: Railroad Medicare Medicare |
$25,717.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53,020.64
|
| Rate for Payer: UHC Core |
$44,358.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25,717.37
|
| Rate for Payer: UHC Exchange |
$36,226.43
|
| Rate for Payer: VA VA |
$25,717.37
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$38,817.49
|
|
|
Service Code
|
MSDRG 262
|
| Min. Negotiated Rate |
$12,516.48 |
| Max. Negotiated Rate |
$38,817.49 |
| Rate for Payer: Aetna Medicare |
$13,702.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,469.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,469.05
|
| Rate for Payer: BCBS MAPPO |
$13,175.24
|
| Rate for Payer: BCBS Trust/PPO |
$38,817.49
|
| Rate for Payer: BCN Commercial |
$38,817.49
|
| Rate for Payer: BCN Medicare Advantage |
$13,175.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,175.24
|
| Rate for Payer: Mclaren Medicare |
$13,175.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,834.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,151.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,492.76
|
| Rate for Payer: Nomi Health Commercial |
$21,025.71
|
| Rate for Payer: PACE Medicare |
$12,516.48
|
| Rate for Payer: PACE SWMI |
$13,175.24
|
| Rate for Payer: PHP Medicare Advantage |
$13,175.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,277.48
|
| Rate for Payer: Priority Health Medicare |
$13,175.24
|
| Rate for Payer: Priority Health Tiered Network |
$21,021.98
|
| Rate for Payer: Railroad Medicare Medicare |
$13,175.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,567.37
|
| Rate for Payer: UHC Core |
$22,226.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,175.24
|
| Rate for Payer: UHC Exchange |
$18,152.20
|
| Rate for Payer: VA VA |
$13,175.24
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$22,660.26
|
|
|
Service Code
|
APR-DRG 2004
|
| Min. Negotiated Rate |
$21,581.20 |
| Max. Negotiated Rate |
$22,660.26 |
| Rate for Payer: BCBS Complete |
$22,660.26
|
| Rate for Payer: Mclaren Medicaid |
$21,581.20
|
| Rate for Payer: Meridian Medicaid |
$22,660.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,581.20
|
| Rate for Payer: UHC Medicaid |
$21,581.20
|
| Rate for Payer: UHCCP Medicaid |
$21,581.20
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$5,520.88
|
|
|
Service Code
|
APR-DRG 2002
|
| Min. Negotiated Rate |
$5,257.98 |
| Max. Negotiated Rate |
$5,520.88 |
| Rate for Payer: BCBS Complete |
$5,520.88
|
| Rate for Payer: Mclaren Medicaid |
$5,257.98
|
| Rate for Payer: Meridian Medicaid |
$5,520.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,257.98
|
| Rate for Payer: UHC Medicaid |
$5,257.98
|
| Rate for Payer: UHCCP Medicaid |
$5,257.98
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$12,067.97
|
|
|
Service Code
|
APR-DRG 2003
|
| Min. Negotiated Rate |
$11,493.30 |
| Max. Negotiated Rate |
$12,067.97 |
| Rate for Payer: BCBS Complete |
$12,067.97
|
| Rate for Payer: Mclaren Medicaid |
$11,493.30
|
| Rate for Payer: Meridian Medicaid |
$12,067.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,493.30
|
| Rate for Payer: UHC Medicaid |
$11,493.30
|
| Rate for Payer: UHCCP Medicaid |
$11,493.30
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$4,047.50
|
|
|
Service Code
|
APR-DRG 2001
|
| Min. Negotiated Rate |
$3,854.76 |
| Max. Negotiated Rate |
$4,047.50 |
| Rate for Payer: BCBS Complete |
$4,047.50
|
| Rate for Payer: Mclaren Medicaid |
$3,854.76
|
| Rate for Payer: Meridian Medicaid |
$4,047.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,854.76
|
| Rate for Payer: UHC Medicaid |
$3,854.76
|
| Rate for Payer: UHCCP Medicaid |
$3,854.76
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$128,708.89
|
|
|
Service Code
|
MSDRG 217
|
| Min. Negotiated Rate |
$48,824.69 |
| Max. Negotiated Rate |
$128,708.89 |
| Rate for Payer: Aetna Medicare |
$53,450.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64,243.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64,243.01
|
| Rate for Payer: BCBS MAPPO |
$51,394.41
|
| Rate for Payer: BCBS Trust/PPO |
$128,708.89
|
| Rate for Payer: BCN Commercial |
$128,708.89
|
| Rate for Payer: BCN Medicare Advantage |
$51,394.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51,394.41
|
| Rate for Payer: Mclaren Medicare |
$51,394.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53,964.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59,103.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$56,533.85
|
| Rate for Payer: Nomi Health Commercial |
$84,821.37
|
| Rate for Payer: PACE Medicare |
$48,824.69
|
| Rate for Payer: PACE SWMI |
$51,394.41
|
| Rate for Payer: PHP Medicare Advantage |
$51,394.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$106,007.91
|
| Rate for Payer: Priority Health Medicare |
$51,394.41
|
| Rate for Payer: Priority Health Tiered Network |
$84,806.31
|
| Rate for Payer: Railroad Medicare Medicare |
$51,394.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107,177.39
|
| Rate for Payer: UHC Core |
$89,667.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51,394.41
|
| Rate for Payer: UHC Exchange |
$73,229.12
|
| Rate for Payer: VA VA |
$51,394.41
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$192,088.39
|
|
|
Service Code
|
MSDRG 216
|
| Min. Negotiated Rate |
$72,373.57 |
| Max. Negotiated Rate |
$192,088.39 |
| Rate for Payer: Aetna Medicare |
$79,230.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95,228.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95,228.39
|
| Rate for Payer: BCBS MAPPO |
$76,182.71
|
| Rate for Payer: BCBS Trust/PPO |
$192,088.39
|
| Rate for Payer: BCN Commercial |
$192,088.39
|
| Rate for Payer: BCN Medicare Advantage |
$76,182.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76,182.71
|
| Rate for Payer: Mclaren Medicare |
$76,182.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79,991.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87,610.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$83,800.98
|
| Rate for Payer: Nomi Health Commercial |
$126,198.12
|
| Rate for Payer: PACE Medicare |
$72,373.57
|
| Rate for Payer: PACE SWMI |
$76,182.71
|
| Rate for Payer: PHP Medicare Advantage |
$76,182.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157,719.67
|
| Rate for Payer: Priority Health Medicare |
$76,182.71
|
| Rate for Payer: Priority Health Tiered Network |
$126,175.72
|
| Rate for Payer: Railroad Medicare Medicare |
$76,182.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159,459.64
|
| Rate for Payer: UHC Core |
$133,408.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76,182.71
|
| Rate for Payer: UHC Exchange |
$108,951.04
|
| Rate for Payer: VA VA |
$76,182.71
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$107,177.39
|
|
|
Service Code
|
MSDRG 218
|
| Min. Negotiated Rate |
$48,824.69 |
| Max. Negotiated Rate |
$107,177.39 |
| Rate for Payer: Aetna Medicare |
$53,450.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64,243.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64,243.01
|
| Rate for Payer: BCBS MAPPO |
$51,394.41
|
| Rate for Payer: BCBS Trust/PPO |
$103,517.20
|
| Rate for Payer: BCN Commercial |
$103,517.20
|
| Rate for Payer: BCN Medicare Advantage |
$51,394.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51,394.41
|
| Rate for Payer: Mclaren Medicare |
$51,394.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53,964.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59,103.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$56,533.85
|
| Rate for Payer: Nomi Health Commercial |
$84,821.37
|
| Rate for Payer: PACE Medicare |
$48,824.69
|
| Rate for Payer: PACE SWMI |
$51,394.41
|
| Rate for Payer: PHP Medicare Advantage |
$51,394.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$106,007.91
|
| Rate for Payer: Priority Health Medicare |
$51,394.41
|
| Rate for Payer: Priority Health Tiered Network |
$84,806.31
|
| Rate for Payer: Railroad Medicare Medicare |
$51,394.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107,177.39
|
| Rate for Payer: UHC Core |
$89,667.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51,394.41
|
| Rate for Payer: UHC Exchange |
$73,229.12
|
| Rate for Payer: VA VA |
$51,394.41
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$103,645.94
|
|
|
Service Code
|
MSDRG 220
|
| Min. Negotiated Rate |
$39,702.49 |
| Max. Negotiated Rate |
$103,645.94 |
| Rate for Payer: Aetna Medicare |
$43,463.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52,240.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52,240.11
|
| Rate for Payer: BCBS MAPPO |
$41,792.09
|
| Rate for Payer: BCBS Trust/PPO |
$103,645.94
|
| Rate for Payer: BCN Commercial |
$103,645.94
|
| Rate for Payer: BCN Medicare Advantage |
$41,792.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41,792.09
|
| Rate for Payer: Mclaren Medicare |
$41,792.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43,881.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48,060.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$45,971.30
|
| Rate for Payer: Nomi Health Commercial |
$68,793.12
|
| Rate for Payer: PACE Medicare |
$39,702.49
|
| Rate for Payer: PACE SWMI |
$41,792.09
|
| Rate for Payer: PHP Medicare Advantage |
$41,792.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85,976.15
|
| Rate for Payer: Priority Health Medicare |
$41,792.09
|
| Rate for Payer: Priority Health Tiered Network |
$68,780.91
|
| Rate for Payer: Railroad Medicare Medicare |
$41,792.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86,924.64
|
| Rate for Payer: UHC Core |
$72,723.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41,792.09
|
| Rate for Payer: UHC Exchange |
$59,391.39
|
| Rate for Payer: VA VA |
$41,792.09
|
|
