|
HH HC NEGATIVE PRESSURE WOUND THERAPY DISPOSAL < 50SQ CM
|
Facility
|
OP
|
$964.48
|
|
|
Service Code
|
CPT 97607
|
| Hospital Charge Code |
76100035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Commercial |
$819.81
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$438.69
|
| Rate for Payer: BCN Commercial |
$438.69
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$771.58
|
| Rate for Payer: Cash Price |
$771.58
|
| Rate for Payer: Cash Price |
$771.58
|
| Rate for Payer: Cofinity Advantage |
$675.14
|
| Rate for Payer: Cofinity Commercial |
$829.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$868.03
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$819.81
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.36
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$819.81
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$607.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.91
|
| Rate for Payer: UHC Core |
$502.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$379.04
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HH HC NEGATIVE PRESSURE WOUND THERAPY DISPOSAL >50SQ CM
|
Facility
|
IP
|
$839.87
|
|
|
Service Code
|
CPT 97608
|
| Hospital Charge Code |
76100036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$529.12 |
| Max. Negotiated Rate |
$755.88 |
| Rate for Payer: Aetna Commercial |
$713.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.92
|
| Rate for Payer: Cash Price |
$671.90
|
| Rate for Payer: Cofinity Advantage |
$587.91
|
| Rate for Payer: Cofinity Commercial |
$722.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$671.90
|
| Rate for Payer: Healthscope Commercial |
$755.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.90
|
| Rate for Payer: PHP Commercial |
$713.89
|
| Rate for Payer: Priority Health SBD |
$529.12
|
|
|
HH HC NEGATIVE PRESSURE WOUND THERAPY DISPOSAL >50SQ CM
|
Facility
|
OP
|
$839.87
|
|
|
Service Code
|
CPT 97608
|
| Hospital Charge Code |
76100036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Commercial |
$713.89
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$457.57
|
| Rate for Payer: BCN Commercial |
$457.57
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$671.90
|
| Rate for Payer: Cash Price |
$671.90
|
| Rate for Payer: Cash Price |
$671.90
|
| Rate for Payer: Cofinity Advantage |
$587.91
|
| Rate for Payer: Cofinity Commercial |
$722.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$671.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$755.88
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.89
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.90
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$713.89
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$529.12
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.92
|
| Rate for Payer: UHC Core |
$437.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$330.07
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HH POUCH 2.5" CTF HOLL8331 EA
|
Facility
|
IP
|
$6.36
|
|
|
Service Code
|
HCPCS A5056
|
| Hospital Charge Code |
27000597
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$5.72 |
| Rate for Payer: Aetna Commercial |
$5.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.13
|
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Cofinity Advantage |
$4.45
|
| Rate for Payer: Cofinity Commercial |
$5.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.09
|
| Rate for Payer: Healthscope Commercial |
$5.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.77
|
| Rate for Payer: PHP Commercial |
$5.41
|
| Rate for Payer: Priority Health SBD |
$4.01
|
|
|
HH POUCH 2.5" CTF HOLL8331 EA
|
Facility
|
OP
|
$6.36
|
|
|
Service Code
|
HCPCS A5056
|
| Hospital Charge Code |
27000597
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Aetna Commercial |
$5.41
|
| Rate for Payer: Aetna Medicare |
$3.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.13
|
| Rate for Payer: BCBS Complete |
$2.54
|
| Rate for Payer: BCBS Trust/PPO |
$18.15
|
| Rate for Payer: BCN Commercial |
$18.15
|
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Cofinity Advantage |
$4.45
|
| Rate for Payer: Cofinity Commercial |
$5.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.09
|
| Rate for Payer: Healthscope Commercial |
$5.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.77
|
| Rate for Payer: PHP Commercial |
$5.41
|
| Rate for Payer: Priority Health SBD |
$4.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.13
|
| Rate for Payer: UHC Core |
$3.31
|
| Rate for Payer: UHC Exchange |
$2.50
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$8,353.55
|
|
|
Service Code
|
APR-DRG 3081
|
| Min. Negotiated Rate |
$7,955.77 |
| Max. Negotiated Rate |
$8,353.55 |
| Rate for Payer: BCBS Complete |
$8,353.55
|
| Rate for Payer: Mclaren Medicaid |
$7,955.77
|
| Rate for Payer: Meridian Medicaid |
$8,353.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,955.77
|
| Rate for Payer: UHC Medicaid |
$7,955.77
|
| Rate for Payer: UHCCP Medicaid |
$7,955.77
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$13,528.16
|
|
|
Service Code
|
APR-DRG 3083
|
| Min. Negotiated Rate |
$12,883.96 |
| Max. Negotiated Rate |
$13,528.16 |
| Rate for Payer: BCBS Complete |
$13,528.16
|
| Rate for Payer: Mclaren Medicaid |
$12,883.96
|
| Rate for Payer: Meridian Medicaid |
$13,528.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,883.96
|
| Rate for Payer: UHC Medicaid |
$12,883.96
|
| Rate for Payer: UHCCP Medicaid |
$12,883.96
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$10,794.09
|
|
|
Service Code
|
APR-DRG 3082
|
| Min. Negotiated Rate |
$10,280.09 |
| Max. Negotiated Rate |
$10,794.09 |
| Rate for Payer: BCBS Complete |
$10,794.09
|
| Rate for Payer: Mclaren Medicaid |
$10,280.09
|
| Rate for Payer: Meridian Medicaid |
$10,794.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,280.09
|
| Rate for Payer: UHC Medicaid |
$10,280.09
|
| Rate for Payer: UHCCP Medicaid |
$10,280.09
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$23,641.75
|
|
|
Service Code
|
APR-DRG 3084
|
| Min. Negotiated Rate |
$22,515.95 |
| Max. Negotiated Rate |
$23,641.75 |
| Rate for Payer: BCBS Complete |
$23,641.75
|
| Rate for Payer: Mclaren Medicaid |
$22,515.95
|
| Rate for Payer: Meridian Medicaid |
$23,641.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,515.95
|
| Rate for Payer: UHC Medicaid |
$22,515.95
|
| Rate for Payer: UHCCP Medicaid |
$22,515.95
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$38,075.45
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$15,927.48 |
| Max. Negotiated Rate |
$38,075.45 |
| Rate for Payer: Aetna Medicare |
$17,436.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,957.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,957.21
|
| Rate for Payer: BCBS MAPPO |
$16,765.77
|
| Rate for Payer: BCBS Trust/PPO |
$38,075.45
|
| Rate for Payer: BCN Commercial |
$38,075.45
|
| Rate for Payer: BCN Medicare Advantage |
$16,765.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,765.77
|
| Rate for Payer: Mclaren Medicare |
$16,765.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,604.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,280.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,442.35
|
| Rate for Payer: Nomi Health Commercial |
$27,019.05
|
| Rate for Payer: PACE Medicare |
$15,927.48
|
| Rate for Payer: PACE SWMI |
$16,765.77
|
| Rate for Payer: PHP Medicare Advantage |
$16,765.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33,767.82
|
| Rate for Payer: Priority Health Medicare |
$16,765.77
|
| Rate for Payer: Priority Health Tiered Network |
$27,014.25
|
| Rate for Payer: Railroad Medicare Medicare |
$16,765.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,140.35
|
| Rate for Payer: UHC Core |
$28,562.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,765.77
|
| Rate for Payer: UHC Exchange |
$23,326.45
|
| Rate for Payer: VA VA |
$16,765.77
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
|
IP
|
$59,664.65
|
|
|
Service Code
|
MSDRG 480
|
| Min. Negotiated Rate |
$21,931.62 |
| Max. Negotiated Rate |
$59,664.65 |
| Rate for Payer: Aetna Medicare |
$24,009.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,857.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,857.40
|
| Rate for Payer: BCBS MAPPO |
$23,085.92
|
| Rate for Payer: BCBS Trust/PPO |
$59,664.65
|
| Rate for Payer: BCN Commercial |
$59,664.65
|
| Rate for Payer: BCN Medicare Advantage |
$23,085.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,085.92
|
| Rate for Payer: Mclaren Medicare |
$23,085.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,240.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,548.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$25,394.51
|
| Rate for Payer: Nomi Health Commercial |
$37,568.67
|
| Rate for Payer: PACE Medicare |
$21,931.62
|
| Rate for Payer: PACE SWMI |
$23,085.92
|
| Rate for Payer: PHP Medicare Advantage |
$23,085.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$46,952.51
|
| Rate for Payer: Priority Health Medicare |
$23,085.92
|
| Rate for Payer: Priority Health Tiered Network |
$37,562.00
|
| Rate for Payer: Railroad Medicare Medicare |
$23,085.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47,470.49
|
| Rate for Payer: UHC Core |
$39,715.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23,085.92
|
| Rate for Payer: UHC Exchange |
$32,434.29
|
| Rate for Payer: VA VA |
$23,085.92
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
|
IP
|
$29,185.09
|
|
|
Service Code
|
MSDRG 482
|
| Min. Negotiated Rate |
$12,524.55 |
| Max. Negotiated Rate |
$29,185.09 |
| Rate for Payer: Aetna Medicare |
$13,711.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,479.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,479.67
|
| Rate for Payer: BCBS MAPPO |
$13,183.74
|
| Rate for Payer: BCBS Trust/PPO |
$29,185.09
|
| Rate for Payer: BCN Commercial |
$29,185.09
|
| Rate for Payer: BCN Medicare Advantage |
$13,183.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,183.74
|
| Rate for Payer: Mclaren Medicare |
$13,183.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,842.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,161.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,502.11
|
| Rate for Payer: Nomi Health Commercial |
$21,039.90
|
| Rate for Payer: PACE Medicare |
$12,524.55
|
| Rate for Payer: PACE SWMI |
$13,183.74
|
| Rate for Payer: PHP Medicare Advantage |
$13,183.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,295.21
|
| Rate for Payer: Priority Health Medicare |
$13,183.74
|
| Rate for Payer: Priority Health Tiered Network |
$21,036.17
|
| Rate for Payer: Railroad Medicare Medicare |
$13,183.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,585.30
|
| Rate for Payer: UHC Core |
$22,241.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,183.74
|
| Rate for Payer: UHC Exchange |
$18,164.45
|
| Rate for Payer: VA VA |
$13,183.74
|
|
|
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
|
IP
|
$70,593.85
|
|
|
Service Code
|
MSDRG 521
|
| Min. Negotiated Rate |
$21,622.53 |
| Max. Negotiated Rate |
$70,593.85 |
| Rate for Payer: Aetna Medicare |
$23,670.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,450.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,450.70
|
| Rate for Payer: BCBS MAPPO |
$22,760.56
|
| Rate for Payer: BCBS Trust/PPO |
$70,593.85
|
| Rate for Payer: BCN Commercial |
$70,593.85
|
| Rate for Payer: BCN Medicare Advantage |
$22,760.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,760.56
|
| Rate for Payer: Mclaren Medicare |
$22,760.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,898.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,174.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$25,036.62
|
| Rate for Payer: Nomi Health Commercial |
$37,025.58
|
| Rate for Payer: PACE Medicare |
$21,622.53
|
| Rate for Payer: PACE SWMI |
$22,760.56
|
| Rate for Payer: PHP Medicare Advantage |
$22,760.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$46,273.77
|
| Rate for Payer: Priority Health Medicare |
$22,760.56
|
| Rate for Payer: Priority Health Tiered Network |
$37,019.01
|
| Rate for Payer: Railroad Medicare Medicare |
$22,760.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46,784.26
|
| Rate for Payer: UHC Core |
$39,140.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,760.56
|
| Rate for Payer: UHC Exchange |
$31,965.42
|
| Rate for Payer: VA VA |
$22,760.56
|
|
|
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
|
IP
|
$40,268.78
|
|
|
Service Code
|
MSDRG 522
|
| Min. Negotiated Rate |
$16,097.83 |
| Max. Negotiated Rate |
$40,268.78 |
| Rate for Payer: BCN Medicare Advantage |
$16,945.08
|
| Rate for Payer: Aetna Medicare |
$17,622.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,181.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,181.35
|
| Rate for Payer: BCBS MAPPO |
$16,945.08
|
| Rate for Payer: BCBS Trust/PPO |
$40,268.78
|
| Rate for Payer: BCN Commercial |
$40,268.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,945.08
|
| Rate for Payer: Mclaren Medicare |
$16,945.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,792.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,486.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,639.59
|
| Rate for Payer: Nomi Health Commercial |
$27,318.33
|
| Rate for Payer: PACE Medicare |
$16,097.83
|
| Rate for Payer: PACE SWMI |
$16,945.08
|
| Rate for Payer: PHP Medicare Advantage |
$16,945.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34,141.86
|
| Rate for Payer: Priority Health Medicare |
$16,945.08
|
| Rate for Payer: Priority Health Tiered Network |
$27,313.48
|
| Rate for Payer: Railroad Medicare Medicare |
$16,945.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,518.51
|
| Rate for Payer: UHC Core |
$28,879.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,945.08
|
| Rate for Payer: UHC Exchange |
$23,584.82
|
| Rate for Payer: VA VA |
$16,945.08
|
|
|
HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$131,803.43
|
|
|
Service Code
|
MSDRG 969
|
| Min. Negotiated Rate |
$45,491.51 |
| Max. Negotiated Rate |
$131,803.43 |
| Rate for Payer: Aetna Medicare |
$49,801.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59,857.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59,857.25
|
| Rate for Payer: BCBS MAPPO |
$47,885.80
|
| Rate for Payer: BCBS Trust/PPO |
$131,803.43
|
| Rate for Payer: BCN Commercial |
$131,803.43
|
| Rate for Payer: BCN Medicare Advantage |
$47,885.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47,885.80
|
| Rate for Payer: Mclaren Medicare |
$47,885.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50,280.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55,068.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$52,674.38
|
| Rate for Payer: Nomi Health Commercial |
$78,964.77
|
| Rate for Payer: PACE Medicare |
$45,491.51
|
| Rate for Payer: PACE SWMI |
$47,885.80
|
| Rate for Payer: PHP Medicare Advantage |
$47,885.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98,688.46
|
| Rate for Payer: Priority Health Medicare |
$47,885.80
|
| Rate for Payer: Priority Health Tiered Network |
$78,950.75
|
| Rate for Payer: Railroad Medicare Medicare |
$47,885.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99,777.19
|
| Rate for Payer: UHC Core |
$83,476.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47,885.80
|
| Rate for Payer: UHC Exchange |
$68,172.92
|
| Rate for Payer: VA VA |
$47,885.80
|
|
|
HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$42,989.62
|
|
|
Service Code
|
MSDRG 970
|
| Min. Negotiated Rate |
$19,913.34 |
| Max. Negotiated Rate |
$42,989.62 |
| Rate for Payer: Aetna Medicare |
$21,799.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,201.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,201.76
|
| Rate for Payer: BCBS MAPPO |
$20,961.41
|
| Rate for Payer: BCBS Trust/PPO |
$42,675.12
|
| Rate for Payer: BCN Commercial |
$42,675.12
|
| Rate for Payer: BCN Medicare Advantage |
$20,961.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,961.41
|
| Rate for Payer: Mclaren Medicare |
$20,961.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,009.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,105.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$23,057.55
|
| Rate for Payer: Nomi Health Commercial |
$34,022.46
|
| Rate for Payer: PACE Medicare |
$19,913.34
|
| Rate for Payer: PACE SWMI |
$20,961.41
|
| Rate for Payer: PHP Medicare Advantage |
$20,961.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42,520.53
|
| Rate for Payer: Priority Health Medicare |
$20,961.41
|
| Rate for Payer: Priority Health Tiered Network |
$34,016.42
|
| Rate for Payer: Railroad Medicare Medicare |
$20,961.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42,989.62
|
| Rate for Payer: UHC Core |
$35,966.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20,961.41
|
| Rate for Payer: UHC Exchange |
$29,372.72
|
| Rate for Payer: VA VA |
$20,961.41
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION OR MULTIPLE HIV SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$10,057.40
|
|
|
Service Code
|
APR-DRG 8914
|
| Min. Negotiated Rate |
$9,578.48 |
| Max. Negotiated Rate |
$10,057.40 |
| Rate for Payer: BCBS Complete |
$10,057.40
|
| Rate for Payer: Mclaren Medicaid |
$9,578.48
|
| Rate for Payer: Meridian Medicaid |
$10,057.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,578.48
|
| Rate for Payer: UHC Medicaid |
$9,578.48
|
| Rate for Payer: UHCCP Medicaid |
$9,578.48
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION OR MULTIPLE HIV SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$4,650.61
|
|
|
Service Code
|
APR-DRG 8912
|
| Min. Negotiated Rate |
$4,429.15 |
| Max. Negotiated Rate |
$4,650.61 |
| Rate for Payer: BCBS Complete |
$4,650.61
|
| Rate for Payer: Mclaren Medicaid |
$4,429.15
|
| Rate for Payer: Meridian Medicaid |
$4,650.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,429.15
|
| Rate for Payer: UHC Medicaid |
$4,429.15
|
| Rate for Payer: UHCCP Medicaid |
$4,429.15
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION OR MULTIPLE HIV SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$6,116.54
|
|
|
Service Code
|
APR-DRG 8913
|
| Min. Negotiated Rate |
$5,825.27 |
| Max. Negotiated Rate |
$6,116.54 |
| Rate for Payer: BCBS Complete |
$6,116.54
|
| Rate for Payer: Mclaren Medicaid |
$5,825.27
|
| Rate for Payer: Meridian Medicaid |
$6,116.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,825.27
|
| Rate for Payer: UHC Medicaid |
$5,825.27
|
| Rate for Payer: UHCCP Medicaid |
$5,825.27
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION OR MULTIPLE HIV SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$4,418.42
|
|
|
Service Code
|
APR-DRG 8911
|
| Min. Negotiated Rate |
$4,208.02 |
| Max. Negotiated Rate |
$4,418.42 |
| Rate for Payer: BCBS Complete |
$4,418.42
|
| Rate for Payer: Mclaren Medicaid |
$4,208.02
|
| Rate for Payer: Meridian Medicaid |
$4,418.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,208.02
|
| Rate for Payer: UHC Medicaid |
$4,208.02
|
| Rate for Payer: UHCCP Medicaid |
$4,208.02
|
|
|
HIV WITH MAJOR RELATED CONDITION WITH CC
|
Facility
|
IP
|
$21,108.50
|
|
|
Service Code
|
MSDRG 975
|
| Min. Negotiated Rate |
$10,057.71 |
| Max. Negotiated Rate |
$21,108.50 |
| Rate for Payer: Aetna Medicare |
$11,010.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,233.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,233.83
|
| Rate for Payer: BCBS MAPPO |
$10,587.06
|
| Rate for Payer: BCBS Trust/PPO |
$13,330.86
|
| Rate for Payer: BCN Commercial |
$13,330.86
|
| Rate for Payer: BCN Medicare Advantage |
$10,587.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,587.06
|
| Rate for Payer: Mclaren Medicare |
$10,587.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,116.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,175.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,645.77
|
| Rate for Payer: Nomi Health Commercial |
$16,705.50
|
| Rate for Payer: PACE Medicare |
$10,057.71
|
| Rate for Payer: PACE SWMI |
$10,587.06
|
| Rate for Payer: PHP Medicare Advantage |
$10,587.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,878.17
|
| Rate for Payer: Priority Health Medicare |
$10,587.06
|
| Rate for Payer: Priority Health Tiered Network |
$16,702.53
|
| Rate for Payer: Railroad Medicare Medicare |
$10,587.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,108.50
|
| Rate for Payer: UHC Core |
$17,659.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,587.06
|
| Rate for Payer: UHC Exchange |
$14,422.42
|
| Rate for Payer: VA VA |
$10,587.06
|
|
|
HIV WITH MAJOR RELATED CONDITION WITH MCC
|
Facility
|
IP
|
$50,774.29
|
|
|
Service Code
|
MSDRG 974
|
| Min. Negotiated Rate |
$21,738.52 |
| Max. Negotiated Rate |
$50,774.29 |
| Rate for Payer: Aetna Medicare |
$23,797.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,603.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,603.31
|
| Rate for Payer: BCBS MAPPO |
$22,882.65
|
| Rate for Payer: BCBS Trust/PPO |
$50,774.29
|
| Rate for Payer: BCN Commercial |
$50,774.29
|
| Rate for Payer: BCN Medicare Advantage |
$22,882.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,882.65
|
| Rate for Payer: Mclaren Medicare |
$22,882.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,026.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,315.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$25,170.92
|
| Rate for Payer: Nomi Health Commercial |
$37,229.40
|
| Rate for Payer: PACE Medicare |
$21,738.52
|
| Rate for Payer: PACE SWMI |
$22,882.65
|
| Rate for Payer: PHP Medicare Advantage |
$22,882.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$46,528.50
|
| Rate for Payer: Priority Health Medicare |
$22,882.65
|
| Rate for Payer: Priority Health Tiered Network |
$37,222.79
|
| Rate for Payer: Railroad Medicare Medicare |
$22,882.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47,041.80
|
| Rate for Payer: UHC Core |
$39,356.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,882.65
|
| Rate for Payer: UHC Exchange |
$32,141.38
|
| Rate for Payer: VA VA |
$22,882.65
|
|
|
HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC
|
Facility
|
IP
|
$14,580.35
|
|
|
Service Code
|
MSDRG 976
|
| Min. Negotiated Rate |
$7,177.52 |
| Max. Negotiated Rate |
$14,580.35 |
| Rate for Payer: Aetna Medicare |
$7,857.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,444.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,444.10
|
| Rate for Payer: BCBS MAPPO |
$7,555.28
|
| Rate for Payer: BCBS Trust/PPO |
$12,944.62
|
| Rate for Payer: BCN Commercial |
$12,944.62
|
| Rate for Payer: BCN Medicare Advantage |
$7,555.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,555.28
|
| Rate for Payer: Mclaren Medicare |
$7,555.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,933.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,688.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,310.81
|
| Rate for Payer: Nomi Health Commercial |
$11,539.05
|
| Rate for Payer: PACE Medicare |
$7,177.52
|
| Rate for Payer: PACE SWMI |
$7,555.28
|
| Rate for Payer: PHP Medicare Advantage |
$7,555.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14,553.46
|
| Rate for Payer: Priority Health Medicare |
$7,555.28
|
| Rate for Payer: Priority Health Tiered Network |
$11,642.76
|
| Rate for Payer: Railroad Medicare Medicare |
$7,555.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,580.35
|
| Rate for Payer: UHC Core |
$12,198.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,555.28
|
| Rate for Payer: UHC Exchange |
$9,962.05
|
| Rate for Payer: VA VA |
$7,555.28
|
|
|
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
|
Facility
|
IP
|
$5,060.52
|
|
|
Service Code
|
APR-DRG 8901
|
| Min. Negotiated Rate |
$4,819.54 |
| Max. Negotiated Rate |
$5,060.52 |
| Rate for Payer: BCBS Complete |
$5,060.52
|
| Rate for Payer: Mclaren Medicaid |
$4,819.54
|
| Rate for Payer: Meridian Medicaid |
$5,060.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,819.54
|
| Rate for Payer: UHC Medicaid |
$4,819.54
|
| Rate for Payer: UHCCP Medicaid |
$4,819.54
|
|
|
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
|
Facility
|
IP
|
$9,410.72
|
|
|
Service Code
|
APR-DRG 8903
|
| Min. Negotiated Rate |
$8,962.59 |
| Max. Negotiated Rate |
$9,410.72 |
| Rate for Payer: BCBS Complete |
$9,410.72
|
| Rate for Payer: Mclaren Medicaid |
$8,962.59
|
| Rate for Payer: Meridian Medicaid |
$9,410.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,962.59
|
| Rate for Payer: UHC Medicaid |
$8,962.59
|
| Rate for Payer: UHCCP Medicaid |
$8,962.59
|
|
