|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$9,411.29
|
|
|
Service Code
|
APR-DRG 4421
|
| Min. Negotiated Rate |
$8,963.14 |
| Max. Negotiated Rate |
$9,411.29 |
| Rate for Payer: BCBS Complete |
$9,411.29
|
| Rate for Payer: Mclaren Medicaid |
$8,963.14
|
| Rate for Payer: Meridian Medicaid |
$9,411.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,963.14
|
| Rate for Payer: UHC Medicaid |
$8,963.14
|
| Rate for Payer: UHCCP Medicaid |
$8,963.14
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$16,836.10
|
|
|
Service Code
|
APR-DRG 4423
|
| Min. Negotiated Rate |
$16,034.38 |
| Max. Negotiated Rate |
$16,836.10 |
| Rate for Payer: BCBS Complete |
$16,836.10
|
| Rate for Payer: Mclaren Medicaid |
$16,034.38
|
| Rate for Payer: Meridian Medicaid |
$16,836.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,034.38
|
| Rate for Payer: UHC Medicaid |
$16,034.38
|
| Rate for Payer: UHCCP Medicaid |
$16,034.38
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$9,151.01
|
|
|
Service Code
|
APR-DRG 4431
|
| Min. Negotiated Rate |
$8,715.25 |
| Max. Negotiated Rate |
$9,151.01 |
| Rate for Payer: BCBS Complete |
$9,151.01
|
| Rate for Payer: Mclaren Medicaid |
$8,715.25
|
| Rate for Payer: Meridian Medicaid |
$9,151.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,715.25
|
| Rate for Payer: UHC Medicaid |
$8,715.25
|
| Rate for Payer: UHCCP Medicaid |
$8,715.25
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$12,057.07
|
|
|
Service Code
|
APR-DRG 4433
|
| Min. Negotiated Rate |
$11,482.93 |
| Max. Negotiated Rate |
$12,057.07 |
| Rate for Payer: BCBS Complete |
$12,057.07
|
| Rate for Payer: Mclaren Medicaid |
$11,482.93
|
| Rate for Payer: Meridian Medicaid |
$12,057.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,482.93
|
| Rate for Payer: UHC Medicaid |
$11,482.93
|
| Rate for Payer: UHCCP Medicaid |
$11,482.93
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$21,003.42
|
|
|
Service Code
|
APR-DRG 4434
|
| Min. Negotiated Rate |
$20,003.26 |
| Max. Negotiated Rate |
$21,003.42 |
| Rate for Payer: BCBS Complete |
$21,003.42
|
| Rate for Payer: Mclaren Medicaid |
$20,003.26
|
| Rate for Payer: Meridian Medicaid |
$21,003.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$20,003.26
|
| Rate for Payer: UHC Medicaid |
$20,003.26
|
| Rate for Payer: UHCCP Medicaid |
$20,003.26
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$10,536.11
|
|
|
Service Code
|
APR-DRG 4432
|
| Min. Negotiated Rate |
$10,034.39 |
| Max. Negotiated Rate |
$10,536.11 |
| Rate for Payer: BCBS Complete |
$10,536.11
|
| Rate for Payer: Mclaren Medicaid |
$10,034.39
|
| Rate for Payer: Meridian Medicaid |
$10,536.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,034.39
|
| Rate for Payer: UHC Medicaid |
$10,034.39
|
| Rate for Payer: UHCCP Medicaid |
$10,034.39
|
|
|
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$18,643.94
|
|
|
Service Code
|
MSDRG 695
|
| Min. Negotiated Rate |
$8,947.61 |
| Max. Negotiated Rate |
$18,643.94 |
| Rate for Payer: Aetna Medicare |
$9,795.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,773.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,773.17
|
| Rate for Payer: BCBS MAPPO |
$9,418.54
|
| Rate for Payer: BCBS Trust/PPO |
$16,624.36
|
| Rate for Payer: BCN Commercial |
$16,624.36
|
| Rate for Payer: BCN Medicare Advantage |
$9,418.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,418.54
|
| Rate for Payer: Mclaren Medicare |
$9,418.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,889.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,831.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,360.39
|
| Rate for Payer: Nomi Health Commercial |
$14,755.02
|
| Rate for Payer: PACE Medicare |
$8,947.61
|
| Rate for Payer: PACE SWMI |
$9,418.54
|
| Rate for Payer: PHP Medicare Advantage |
$9,418.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,440.50
|
| Rate for Payer: Priority Health Medicare |
$9,418.54
|
| Rate for Payer: Priority Health Tiered Network |
$14,752.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9,418.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,643.94
|
| Rate for Payer: UHC Core |
$15,598.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,418.54
|
| Rate for Payer: UHC Exchange |
$12,738.50
|
| Rate for Payer: VA VA |
$9,418.54
|
|
|
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$11,230.70
|
|
|
Service Code
|
MSDRG 696
|
| Min. Negotiated Rate |
$5,608.55 |
| Max. Negotiated Rate |
$11,230.70 |
| Rate for Payer: Aetna Medicare |
$6,139.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,379.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,379.68
|
| Rate for Payer: BCBS MAPPO |
$5,903.74
|
| Rate for Payer: BCBS Trust/PPO |
$9,154.87
|
| Rate for Payer: BCN Commercial |
$9,154.87
|
| Rate for Payer: BCN Medicare Advantage |
$5,903.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,903.74
|
| Rate for Payer: Mclaren Medicare |
$5,903.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,198.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,789.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,494.11
|
| Rate for Payer: Nomi Health Commercial |
$8,888.10
|
| Rate for Payer: PACE Medicare |
$5,608.55
|
| Rate for Payer: PACE SWMI |
$5,903.74
|
| Rate for Payer: PHP Medicare Advantage |
$5,903.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,108.15
|
| Rate for Payer: Priority Health Medicare |
$5,903.74
|
| Rate for Payer: Priority Health Tiered Network |
$8,886.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5,903.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,230.70
|
| Rate for Payer: UHC Core |
$9,395.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,903.74
|
| Rate for Payer: UHC Exchange |
$7,673.39
|
| Rate for Payer: VA VA |
$5,903.74
|
|
|
KIDNEY TRANSPLANT
|
Facility
|
IP
|
$143,036.92
|
|
|
Service Code
|
MSDRG 652
|
| Min. Negotiated Rate |
$24,260.46 |
| Max. Negotiated Rate |
$143,036.92 |
| Rate for Payer: Aetna Medicare |
$26,558.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,921.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,921.66
|
| Rate for Payer: BCBS MAPPO |
$25,537.33
|
| Rate for Payer: BCBS Trust/PPO |
$143,036.92
|
| Rate for Payer: BCN Commercial |
$143,036.92
|
| Rate for Payer: BCN Medicare Advantage |
$25,537.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,537.33
|
| Rate for Payer: Mclaren Medicare |
$25,537.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,814.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,367.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,091.06
|
| Rate for Payer: Nomi Health Commercial |
$41,660.55
|
| Rate for Payer: PACE Medicare |
$24,260.46
|
| Rate for Payer: PACE SWMI |
$25,537.33
|
| Rate for Payer: PHP Medicare Advantage |
$25,537.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$52,066.45
|
| Rate for Payer: Priority Health Medicare |
$25,537.33
|
| Rate for Payer: Priority Health Tiered Network |
$41,653.15
|
| Rate for Payer: Railroad Medicare Medicare |
$25,537.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52,640.85
|
| Rate for Payer: UHC Core |
$44,040.69
|
| Rate for Payer: UHC Exchange |
$35,966.94
|
| Rate for Payer: VA VA |
$25,537.33
|
|
|
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC
|
Facility
|
IP
|
$179,750.03
|
|
|
Service Code
|
MSDRG 650
|
| Min. Negotiated Rate |
$35,066.86 |
| Max. Negotiated Rate |
$179,750.03 |
| Rate for Payer: Aetna Medicare |
$38,388.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46,140.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46,140.60
|
| Rate for Payer: BCBS MAPPO |
$36,912.48
|
| Rate for Payer: BCBS Trust/PPO |
$179,750.03
|
| Rate for Payer: BCN Commercial |
$179,750.03
|
| Rate for Payer: BCN Medicare Advantage |
$36,912.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,912.48
|
| Rate for Payer: Mclaren Medicare |
$36,912.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,758.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,449.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$40,603.73
|
| Rate for Payer: Nomi Health Commercial |
$60,648.06
|
| Rate for Payer: PACE Medicare |
$35,066.86
|
| Rate for Payer: PACE SWMI |
$36,912.48
|
| Rate for Payer: PHP Medicare Advantage |
$36,912.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75,796.63
|
| Rate for Payer: Priority Health Medicare |
$36,912.48
|
| Rate for Payer: Priority Health Tiered Network |
$60,637.29
|
| Rate for Payer: Railroad Medicare Medicare |
$36,912.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76,632.82
|
| Rate for Payer: UHC Core |
$64,112.99
|
| Rate for Payer: UHC Exchange |
$52,359.49
|
| Rate for Payer: VA VA |
$36,912.48
|
|
|
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC
|
Facility
|
IP
|
$114,760.06
|
|
|
Service Code
|
MSDRG 651
|
| Min. Negotiated Rate |
$27,757.36 |
| Max. Negotiated Rate |
$114,760.06 |
| Rate for Payer: Aetna Medicare |
$30,387.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,522.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,522.84
|
| Rate for Payer: BCBS MAPPO |
$29,218.27
|
| Rate for Payer: BCBS Trust/PPO |
$114,760.06
|
| Rate for Payer: BCN Commercial |
$114,760.06
|
| Rate for Payer: BCN Medicare Advantage |
$29,218.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,218.27
|
| Rate for Payer: Mclaren Medicare |
$29,218.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,679.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,601.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$32,140.10
|
| Rate for Payer: Nomi Health Commercial |
$47,804.82
|
| Rate for Payer: PACE Medicare |
$27,757.36
|
| Rate for Payer: PACE SWMI |
$29,218.27
|
| Rate for Payer: PHP Medicare Advantage |
$29,218.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,745.43
|
| Rate for Payer: Priority Health Medicare |
$29,218.27
|
| Rate for Payer: Priority Health Tiered Network |
$47,796.33
|
| Rate for Payer: Railroad Medicare Medicare |
$29,218.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60,404.54
|
| Rate for Payer: UHC Core |
$50,535.99
|
| Rate for Payer: UHC Exchange |
$41,271.49
|
| Rate for Payer: VA VA |
$29,218.27
|
|
|
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT
|
Facility
|
IP
|
$12,289.83
|
|
|
Service Code
|
APR-DRG 3132
|
| Min. Negotiated Rate |
$11,704.60 |
| Max. Negotiated Rate |
$12,289.83 |
| Rate for Payer: BCBS Complete |
$12,289.83
|
| Rate for Payer: Mclaren Medicaid |
$11,704.60
|
| Rate for Payer: Meridian Medicaid |
$12,289.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,704.60
|
| Rate for Payer: UHC Medicaid |
$11,704.60
|
| Rate for Payer: UHCCP Medicaid |
$11,704.60
|
|
|
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT
|
Facility
|
IP
|
$9,709.98
|
|
|
Service Code
|
APR-DRG 3131
|
| Min. Negotiated Rate |
$9,247.60 |
| Max. Negotiated Rate |
$9,709.98 |
| Rate for Payer: BCBS Complete |
$9,709.98
|
| Rate for Payer: Mclaren Medicaid |
$9,247.60
|
| Rate for Payer: Meridian Medicaid |
$9,709.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,247.60
|
| Rate for Payer: UHC Medicaid |
$9,247.60
|
| Rate for Payer: UHCCP Medicaid |
$9,247.60
|
|
|
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT
|
Facility
|
IP
|
$14,809.49
|
|
|
Service Code
|
APR-DRG 3133
|
| Min. Negotiated Rate |
$14,104.27 |
| Max. Negotiated Rate |
$14,809.49 |
| Rate for Payer: BCBS Complete |
$14,809.49
|
| Rate for Payer: Mclaren Medicaid |
$14,104.27
|
| Rate for Payer: Meridian Medicaid |
$14,809.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,104.27
|
| Rate for Payer: UHC Medicaid |
$14,104.27
|
| Rate for Payer: UHCCP Medicaid |
$14,104.27
|
|
|
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT
|
Facility
|
IP
|
$24,729.30
|
|
|
Service Code
|
APR-DRG 3134
|
| Min. Negotiated Rate |
$23,551.71 |
| Max. Negotiated Rate |
$24,729.30 |
| Rate for Payer: BCBS Complete |
$24,729.30
|
| Rate for Payer: Mclaren Medicaid |
$23,551.71
|
| Rate for Payer: Meridian Medicaid |
$24,729.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,551.71
|
| Rate for Payer: UHC Medicaid |
$23,551.71
|
| Rate for Payer: UHCCP Medicaid |
$23,551.71
|
|
|
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC
|
Facility
|
IP
|
$30,034.80
|
|
|
Service Code
|
MSDRG 488
|
| Min. Negotiated Rate |
$13,537.00 |
| Max. Negotiated Rate |
$30,034.80 |
| Rate for Payer: Aetna Medicare |
$14,819.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,811.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,811.84
|
| Rate for Payer: BCBS MAPPO |
$14,249.47
|
| Rate for Payer: BCBS Trust/PPO |
$30,034.80
|
| Rate for Payer: BCN Commercial |
$30,034.80
|
| Rate for Payer: BCN Medicare Advantage |
$14,249.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,249.47
|
| Rate for Payer: Mclaren Medicare |
$14,249.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,961.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,386.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,674.42
|
| Rate for Payer: Nomi Health Commercial |
$19,654.44
|
| Rate for Payer: PACE Medicare |
$13,537.00
|
| Rate for Payer: PACE SWMI |
$14,249.47
|
| Rate for Payer: PHP Medicare Advantage |
$14,249.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,518.45
|
| Rate for Payer: Priority Health Medicare |
$14,249.47
|
| Rate for Payer: Priority Health Tiered Network |
$22,814.76
|
| Rate for Payer: Railroad Medicare Medicare |
$14,249.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,834.68
|
| Rate for Payer: UHC Core |
$20,777.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,249.47
|
| Rate for Payer: UHC Exchange |
$16,968.33
|
| Rate for Payer: VA VA |
$14,249.47
|
|
|
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$19,229.67
|
|
|
Service Code
|
MSDRG 489
|
| Min. Negotiated Rate |
$8,749.39 |
| Max. Negotiated Rate |
$19,229.67 |
| Rate for Payer: Aetna Medicare |
$9,578.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,512.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,512.35
|
| Rate for Payer: BCBS MAPPO |
$9,209.88
|
| Rate for Payer: BCBS Trust/PPO |
$19,229.67
|
| Rate for Payer: BCN Commercial |
$19,229.67
|
| Rate for Payer: BCN Medicare Advantage |
$9,209.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,209.88
|
| Rate for Payer: Mclaren Medicare |
$9,209.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,670.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,591.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,130.87
|
| Rate for Payer: Nomi Health Commercial |
$14,406.72
|
| Rate for Payer: PACE Medicare |
$8,749.39
|
| Rate for Payer: PACE SWMI |
$9,209.88
|
| Rate for Payer: PHP Medicare Advantage |
$9,209.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,005.21
|
| Rate for Payer: Priority Health Medicare |
$9,209.88
|
| Rate for Payer: Priority Health Tiered Network |
$14,404.16
|
| Rate for Payer: Railroad Medicare Medicare |
$9,209.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,203.84
|
| Rate for Payer: UHC Core |
$15,229.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,209.88
|
| Rate for Payer: UHC Exchange |
$12,437.80
|
| Rate for Payer: VA VA |
$9,209.88
|
|
|
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC
|
Facility
|
IP
|
$34,084.93
|
|
|
Service Code
|
MSDRG 486
|
| Min. Negotiated Rate |
$15,902.51 |
| Max. Negotiated Rate |
$34,084.93 |
| Rate for Payer: Aetna Medicare |
$17,409.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,924.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,924.35
|
| Rate for Payer: BCBS MAPPO |
$16,739.48
|
| Rate for Payer: BCBS Trust/PPO |
$31,521.21
|
| Rate for Payer: BCN Commercial |
$31,521.21
|
| Rate for Payer: BCN Medicare Advantage |
$16,739.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,739.48
|
| Rate for Payer: Mclaren Medicare |
$16,739.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,576.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,250.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,413.43
|
| Rate for Payer: Nomi Health Commercial |
$26,975.19
|
| Rate for Payer: PACE Medicare |
$15,902.51
|
| Rate for Payer: PACE SWMI |
$16,739.48
|
| Rate for Payer: PHP Medicare Advantage |
$16,739.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33,713.01
|
| Rate for Payer: Priority Health Medicare |
$16,739.48
|
| Rate for Payer: Priority Health Tiered Network |
$26,970.40
|
| Rate for Payer: Railroad Medicare Medicare |
$16,739.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,084.93
|
| Rate for Payer: UHC Core |
$28,516.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,739.48
|
| Rate for Payer: UHC Exchange |
$23,288.58
|
| Rate for Payer: VA VA |
$16,739.48
|
|
|
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC
|
Facility
|
IP
|
$52,601.73
|
|
|
Service Code
|
MSDRG 485
|
| Min. Negotiated Rate |
$24,242.81 |
| Max. Negotiated Rate |
$52,601.73 |
| Rate for Payer: Aetna Medicare |
$26,539.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,898.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,898.44
|
| Rate for Payer: BCBS MAPPO |
$25,518.75
|
| Rate for Payer: BCBS Trust/PPO |
$47,462.06
|
| Rate for Payer: BCN Commercial |
$47,462.06
|
| Rate for Payer: BCN Medicare Advantage |
$25,518.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,518.75
|
| Rate for Payer: Mclaren Medicare |
$25,518.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,794.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,346.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,070.62
|
| Rate for Payer: Nomi Health Commercial |
$41,629.59
|
| Rate for Payer: PACE Medicare |
$24,242.81
|
| Rate for Payer: PACE SWMI |
$25,518.75
|
| Rate for Payer: PHP Medicare Advantage |
$25,518.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$52,027.76
|
| Rate for Payer: Priority Health Medicare |
$25,518.75
|
| Rate for Payer: Priority Health Tiered Network |
$41,622.20
|
| Rate for Payer: Railroad Medicare Medicare |
$25,518.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52,601.73
|
| Rate for Payer: UHC Core |
$44,007.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25,518.75
|
| Rate for Payer: UHC Exchange |
$35,940.21
|
| Rate for Payer: VA VA |
$25,518.75
|
|
|
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$25,529.06
|
|
|
Service Code
|
MSDRG 487
|
| Min. Negotiated Rate |
$12,048.79 |
| Max. Negotiated Rate |
$25,529.06 |
| Rate for Payer: Aetna Medicare |
$13,190.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,853.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,853.67
|
| Rate for Payer: BCBS MAPPO |
$12,682.94
|
| Rate for Payer: BCBS Trust/PPO |
$24,592.44
|
| Rate for Payer: BCN Commercial |
$24,592.44
|
| Rate for Payer: BCN Medicare Advantage |
$12,682.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,682.94
|
| Rate for Payer: Mclaren Medicare |
$12,682.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,317.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,585.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,951.23
|
| Rate for Payer: Nomi Health Commercial |
$20,203.98
|
| Rate for Payer: PACE Medicare |
$12,048.79
|
| Rate for Payer: PACE SWMI |
$12,682.94
|
| Rate for Payer: PHP Medicare Advantage |
$12,682.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,250.50
|
| Rate for Payer: Priority Health Medicare |
$12,682.94
|
| Rate for Payer: Priority Health Tiered Network |
$20,200.39
|
| Rate for Payer: Railroad Medicare Medicare |
$12,682.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,529.06
|
| Rate for Payer: UHC Core |
$21,358.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,682.94
|
| Rate for Payer: UHC Exchange |
$17,442.77
|
| Rate for Payer: VA VA |
$12,682.94
|
|
|
LABETALOL 200 MG TABLET
|
Facility
|
IP
|
$2,079.75
|
|
|
Service Code
|
NDC 70377006113
|
| Hospital Charge Code |
10374
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,310.24 |
| Max. Negotiated Rate |
$1,871.78 |
| Rate for Payer: Aetna Commercial |
$1,767.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.84
|
| Rate for Payer: Cash Price |
$1,663.80
|
| Rate for Payer: Cofinity Advantage |
$1,455.83
|
| Rate for Payer: Cofinity Commercial |
$1,788.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,663.80
|
| Rate for Payer: Healthscope Commercial |
$1,871.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,767.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,559.81
|
| Rate for Payer: PHP Commercial |
$1,767.79
|
| Rate for Payer: Priority Health SBD |
$1,310.24
|
|
|
LABETALOL 200 MG TABLET
|
Facility
|
OP
|
$434.75
|
|
|
Service Code
|
NDC 70377006112
|
| Hospital Charge Code |
10374
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.86 |
| Max. Negotiated Rate |
$391.27 |
| Rate for Payer: Aetna Commercial |
$369.54
|
| Rate for Payer: Aetna Medicare |
$217.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.59
|
| Rate for Payer: BCBS Complete |
$173.90
|
| Rate for Payer: Cash Price |
$347.80
|
| Rate for Payer: Cofinity Advantage |
$304.32
|
| Rate for Payer: Cofinity Commercial |
$373.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.80
|
| Rate for Payer: Healthscope Commercial |
$391.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$347.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$326.06
|
| Rate for Payer: PHP Commercial |
$369.54
|
| Rate for Payer: Priority Health SBD |
$273.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.59
|
| Rate for Payer: UHC Core |
$226.50
|
| Rate for Payer: UHC Exchange |
$170.86
|
|
|
LABETALOL 200 MG TABLET
|
Facility
|
OP
|
$290.70
|
|
|
Service Code
|
NDC 00904711061
|
| Hospital Charge Code |
10374
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.25 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.09
|
| Rate for Payer: Aetna Medicare |
$145.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.96
|
| Rate for Payer: BCBS Complete |
$116.28
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Advantage |
$203.49
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$232.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.03
|
| Rate for Payer: PHP Commercial |
$247.09
|
| Rate for Payer: Priority Health SBD |
$183.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.96
|
| Rate for Payer: UHC Core |
$151.45
|
| Rate for Payer: UHC Exchange |
$114.25
|
|
|
LABETALOL 200 MG TABLET
|
Facility
|
IP
|
$270.24
|
|
|
Service Code
|
NDC 60687045001
|
| Hospital Charge Code |
10374
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.25 |
| Max. Negotiated Rate |
$243.22 |
| Rate for Payer: Aetna Commercial |
$229.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.66
|
| Rate for Payer: Cash Price |
$216.19
|
| Rate for Payer: Cofinity Advantage |
$189.17
|
| Rate for Payer: Cofinity Commercial |
$232.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.19
|
| Rate for Payer: Healthscope Commercial |
$243.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.68
|
| Rate for Payer: PHP Commercial |
$229.70
|
| Rate for Payer: Priority Health SBD |
$170.25
|
|
|
LABETALOL 200 MG TABLET
|
Facility
|
OP
|
$3.85
|
|
|
Service Code
|
NDC 51079092901
|
| Hospital Charge Code |
10374
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.51 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Aetna Commercial |
$3.27
|
| Rate for Payer: Aetna Medicare |
$1.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.50
|
| Rate for Payer: BCBS Complete |
$1.54
|
| Rate for Payer: Cash Price |
$3.08
|
| Rate for Payer: Cofinity Advantage |
$2.69
|
| Rate for Payer: Cofinity Commercial |
$3.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.08
|
| Rate for Payer: Healthscope Commercial |
$3.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.89
|
| Rate for Payer: PHP Commercial |
$3.27
|
| Rate for Payer: Priority Health SBD |
$2.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.50
|
| Rate for Payer: UHC Core |
$2.01
|
| Rate for Payer: UHC Exchange |
$1.51
|
|
