|
MAJOR CHEST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$37,981.82
|
|
|
Service Code
|
MSDRG 165
|
| Min. Negotiated Rate |
$14,603.76 |
| Max. Negotiated Rate |
$37,981.82 |
| Rate for Payer: Aetna Medicare |
$15,987.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,215.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,215.47
|
| Rate for Payer: BCBS MAPPO |
$15,372.38
|
| Rate for Payer: BCBS Trust/PPO |
$37,981.82
|
| Rate for Payer: BCN Commercial |
$37,981.82
|
| Rate for Payer: BCN Medicare Advantage |
$15,372.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,372.38
|
| Rate for Payer: Mclaren Medicare |
$15,372.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,141.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,678.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,909.62
|
| Rate for Payer: Nomi Health Commercial |
$24,693.18
|
| Rate for Payer: PACE Medicare |
$14,603.76
|
| Rate for Payer: PACE SWMI |
$15,372.38
|
| Rate for Payer: PHP Medicare Advantage |
$15,372.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30,861.00
|
| Rate for Payer: Priority Health Medicare |
$15,372.38
|
| Rate for Payer: Priority Health Tiered Network |
$24,688.80
|
| Rate for Payer: Railroad Medicare Medicare |
$15,372.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,201.46
|
| Rate for Payer: UHC Core |
$26,103.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,372.38
|
| Rate for Payer: UHC Exchange |
$21,318.45
|
| Rate for Payer: VA VA |
$15,372.38
|
|
|
MAJOR CHEST TRAUMA WITH CC
|
Facility
|
IP
|
$18,094.38
|
|
|
Service Code
|
MSDRG 184
|
| Min. Negotiated Rate |
$8,362.47 |
| Max. Negotiated Rate |
$18,094.38 |
| Rate for Payer: Aetna Medicare |
$9,154.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,003.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,003.25
|
| Rate for Payer: BCBS MAPPO |
$8,802.60
|
| Rate for Payer: BCBS Trust/PPO |
$18,094.38
|
| Rate for Payer: BCN Commercial |
$18,094.38
|
| Rate for Payer: BCN Medicare Advantage |
$8,802.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,802.60
|
| Rate for Payer: Mclaren Medicare |
$8,802.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,242.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,122.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,682.86
|
| Rate for Payer: Nomi Health Commercial |
$13,726.89
|
| Rate for Payer: PACE Medicare |
$8,362.47
|
| Rate for Payer: PACE SWMI |
$8,802.60
|
| Rate for Payer: PHP Medicare Advantage |
$8,802.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,155.57
|
| Rate for Payer: Priority Health Medicare |
$8,802.60
|
| Rate for Payer: Priority Health Tiered Network |
$13,724.45
|
| Rate for Payer: Railroad Medicare Medicare |
$8,802.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,344.83
|
| Rate for Payer: UHC Core |
$14,511.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,802.60
|
| Rate for Payer: UHC Exchange |
$11,850.88
|
| Rate for Payer: VA VA |
$8,802.60
|
|
|
MAJOR CHEST TRAUMA WITH MCC
|
Facility
|
IP
|
$24,937.37
|
|
|
Service Code
|
MSDRG 183
|
| Min. Negotiated Rate |
$11,782.31 |
| Max. Negotiated Rate |
$24,937.37 |
| Rate for Payer: Aetna Medicare |
$12,898.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,503.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,503.04
|
| Rate for Payer: BCBS MAPPO |
$12,402.43
|
| Rate for Payer: BCBS Trust/PPO |
$20,790.99
|
| Rate for Payer: BCN Commercial |
$20,790.99
|
| Rate for Payer: BCN Medicare Advantage |
$12,402.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,402.43
|
| Rate for Payer: Mclaren Medicare |
$12,402.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,022.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,262.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,642.67
|
| Rate for Payer: Nomi Health Commercial |
$19,735.71
|
| Rate for Payer: PACE Medicare |
$11,782.31
|
| Rate for Payer: PACE SWMI |
$12,402.43
|
| Rate for Payer: PHP Medicare Advantage |
$12,402.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,665.26
|
| Rate for Payer: Priority Health Medicare |
$12,402.43
|
| Rate for Payer: Priority Health Tiered Network |
$19,732.21
|
| Rate for Payer: Railroad Medicare Medicare |
$12,402.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,937.37
|
| Rate for Payer: UHC Core |
$20,863.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,402.43
|
| Rate for Payer: UHC Exchange |
$17,038.50
|
| Rate for Payer: VA VA |
$12,402.43
|
|
|
MAJOR CHEST TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$14,365.49
|
|
|
Service Code
|
MSDRG 185
|
| Min. Negotiated Rate |
$6,324.39 |
| Max. Negotiated Rate |
$14,365.49 |
| Rate for Payer: Aetna Medicare |
$6,923.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,321.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,321.56
|
| Rate for Payer: BCBS MAPPO |
$6,657.25
|
| Rate for Payer: BCBS Trust/PPO |
$14,365.49
|
| Rate for Payer: BCN Commercial |
$14,365.49
|
| Rate for Payer: BCN Medicare Advantage |
$6,657.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,657.25
|
| Rate for Payer: Mclaren Medicare |
$6,657.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,990.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,655.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,322.98
|
| Rate for Payer: Nomi Health Commercial |
$10,145.85
|
| Rate for Payer: PACE Medicare |
$6,324.39
|
| Rate for Payer: PACE SWMI |
$6,657.25
|
| Rate for Payer: PHP Medicare Advantage |
$6,657.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,680.06
|
| Rate for Payer: Priority Health Medicare |
$6,657.25
|
| Rate for Payer: Priority Health Tiered Network |
$10,144.05
|
| Rate for Payer: Railroad Medicare Medicare |
$6,657.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,819.95
|
| Rate for Payer: UHC Core |
$10,725.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,657.25
|
| Rate for Payer: UHC Exchange |
$8,759.25
|
| Rate for Payer: VA VA |
$6,657.25
|
|
|
MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$12,281.81
|
|
|
Service Code
|
APR-DRG 0891
|
| Min. Negotiated Rate |
$11,696.96 |
| Max. Negotiated Rate |
$12,281.81 |
| Rate for Payer: BCBS Complete |
$12,281.81
|
| Rate for Payer: Mclaren Medicaid |
$11,696.96
|
| Rate for Payer: Meridian Medicaid |
$12,281.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,696.96
|
| Rate for Payer: UHC Medicaid |
$11,696.96
|
| Rate for Payer: UHCCP Medicaid |
$11,696.96
|
|
|
MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$34,148.61
|
|
|
Service Code
|
APR-DRG 0894
|
| Min. Negotiated Rate |
$32,522.49 |
| Max. Negotiated Rate |
$34,148.61 |
| Rate for Payer: BCBS Complete |
$34,148.61
|
| Rate for Payer: Mclaren Medicaid |
$32,522.49
|
| Rate for Payer: Meridian Medicaid |
$34,148.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$32,522.49
|
| Rate for Payer: UHC Medicaid |
$32,522.49
|
| Rate for Payer: UHCCP Medicaid |
$32,522.49
|
|
|
MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$23,959.93
|
|
|
Service Code
|
APR-DRG 0893
|
| Min. Negotiated Rate |
$22,818.98 |
| Max. Negotiated Rate |
$23,959.93 |
| Rate for Payer: BCBS Complete |
$23,959.93
|
| Rate for Payer: Mclaren Medicaid |
$22,818.98
|
| Rate for Payer: Meridian Medicaid |
$23,959.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,818.98
|
| Rate for Payer: UHC Medicaid |
$22,818.98
|
| Rate for Payer: UHCCP Medicaid |
$22,818.98
|
|
|
MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$17,598.02
|
|
|
Service Code
|
APR-DRG 0892
|
| Min. Negotiated Rate |
$16,760.02 |
| Max. Negotiated Rate |
$17,598.02 |
| Rate for Payer: BCBS Complete |
$17,598.02
|
| Rate for Payer: Mclaren Medicaid |
$16,760.02
|
| Rate for Payer: Meridian Medicaid |
$17,598.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,760.02
|
| Rate for Payer: UHC Medicaid |
$16,760.02
|
| Rate for Payer: UHCCP Medicaid |
$16,760.02
|
|
|
MAJOR ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$4,268.79
|
|
|
Service Code
|
APR-DRG 2421
|
| Min. Negotiated Rate |
$4,065.52 |
| Max. Negotiated Rate |
$4,268.79 |
| Rate for Payer: BCBS Complete |
$4,268.79
|
| Rate for Payer: Mclaren Medicaid |
$4,065.52
|
| Rate for Payer: Meridian Medicaid |
$4,268.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,065.52
|
| Rate for Payer: UHC Medicaid |
$4,065.52
|
| Rate for Payer: UHCCP Medicaid |
$4,065.52
|
|
|
MAJOR ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$12,745.03
|
|
|
Service Code
|
APR-DRG 2424
|
| Min. Negotiated Rate |
$12,138.13 |
| Max. Negotiated Rate |
$12,745.03 |
| Rate for Payer: BCBS Complete |
$12,745.03
|
| Rate for Payer: Mclaren Medicaid |
$12,138.13
|
| Rate for Payer: Meridian Medicaid |
$12,745.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,138.13
|
| Rate for Payer: UHC Medicaid |
$12,138.13
|
| Rate for Payer: UHCCP Medicaid |
$12,138.13
|
|
|
MAJOR ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$8,338.08
|
|
|
Service Code
|
APR-DRG 2423
|
| Min. Negotiated Rate |
$7,941.02 |
| Max. Negotiated Rate |
$8,338.08 |
| Rate for Payer: BCBS Complete |
$8,338.08
|
| Rate for Payer: Mclaren Medicaid |
$7,941.02
|
| Rate for Payer: Meridian Medicaid |
$8,338.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,941.02
|
| Rate for Payer: UHC Medicaid |
$7,941.02
|
| Rate for Payer: UHCCP Medicaid |
$7,941.02
|
|
|
MAJOR ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$5,885.50
|
|
|
Service Code
|
APR-DRG 2422
|
| Min. Negotiated Rate |
$5,605.24 |
| Max. Negotiated Rate |
$5,885.50 |
| Rate for Payer: BCBS Complete |
$5,885.50
|
| Rate for Payer: Mclaren Medicaid |
$5,605.24
|
| Rate for Payer: Meridian Medicaid |
$5,885.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,605.24
|
| Rate for Payer: UHC Medicaid |
$5,605.24
|
| Rate for Payer: UHCCP Medicaid |
$5,605.24
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITH CC
|
Facility
|
IP
|
$19,639.31
|
|
|
Service Code
|
MSDRG 369
|
| Min. Negotiated Rate |
$7,893.34 |
| Max. Negotiated Rate |
$19,639.31 |
| Rate for Payer: Aetna Medicare |
$8,641.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,385.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,385.98
|
| Rate for Payer: BCBS MAPPO |
$8,308.78
|
| Rate for Payer: BCBS Trust/PPO |
$19,639.31
|
| Rate for Payer: BCN Commercial |
$19,639.31
|
| Rate for Payer: BCN Medicare Advantage |
$8,308.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,308.78
|
| Rate for Payer: Mclaren Medicare |
$8,308.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,724.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,555.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,139.66
|
| Rate for Payer: Nomi Health Commercial |
$12,902.58
|
| Rate for Payer: PACE Medicare |
$7,893.34
|
| Rate for Payer: PACE SWMI |
$8,308.78
|
| Rate for Payer: PHP Medicare Advantage |
$8,308.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,125.36
|
| Rate for Payer: Priority Health Medicare |
$8,308.78
|
| Rate for Payer: Priority Health Tiered Network |
$12,900.29
|
| Rate for Payer: Railroad Medicare Medicare |
$8,308.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,303.26
|
| Rate for Payer: UHC Core |
$13,639.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,308.78
|
| Rate for Payer: UHC Exchange |
$11,139.23
|
| Rate for Payer: VA VA |
$8,308.78
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITH MCC
|
Facility
|
IP
|
$27,083.06
|
|
|
Service Code
|
MSDRG 368
|
| Min. Negotiated Rate |
$12,237.49 |
| Max. Negotiated Rate |
$27,083.06 |
| Rate for Payer: Aetna Medicare |
$13,396.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,101.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,101.96
|
| Rate for Payer: BCBS MAPPO |
$12,881.57
|
| Rate for Payer: BCBS Trust/PPO |
$27,083.06
|
| Rate for Payer: BCN Commercial |
$27,083.06
|
| Rate for Payer: BCN Medicare Advantage |
$12,881.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,881.57
|
| Rate for Payer: Mclaren Medicare |
$12,881.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,525.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,813.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,169.73
|
| Rate for Payer: Nomi Health Commercial |
$20,535.51
|
| Rate for Payer: PACE Medicare |
$12,237.49
|
| Rate for Payer: PACE SWMI |
$12,881.57
|
| Rate for Payer: PHP Medicare Advantage |
$12,881.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,664.83
|
| Rate for Payer: Priority Health Medicare |
$12,881.57
|
| Rate for Payer: Priority Health Tiered Network |
$20,531.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12,881.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,947.97
|
| Rate for Payer: UHC Core |
$21,708.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,881.57
|
| Rate for Payer: UHC Exchange |
$17,728.99
|
| Rate for Payer: VA VA |
$12,881.57
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,522.80
|
|
|
Service Code
|
MSDRG 370
|
| Min. Negotiated Rate |
$5,695.20 |
| Max. Negotiated Rate |
$13,522.80 |
| Rate for Payer: Aetna Medicare |
$6,234.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,493.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,493.69
|
| Rate for Payer: BCBS MAPPO |
$5,994.95
|
| Rate for Payer: BCBS Trust/PPO |
$13,522.80
|
| Rate for Payer: BCN Commercial |
$13,522.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,994.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,994.95
|
| Rate for Payer: Mclaren Medicare |
$5,994.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,294.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,894.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,594.44
|
| Rate for Payer: Nomi Health Commercial |
$9,040.32
|
| Rate for Payer: PACE Medicare |
$5,695.20
|
| Rate for Payer: PACE SWMI |
$5,994.95
|
| Rate for Payer: PHP Medicare Advantage |
$5,994.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,298.40
|
| Rate for Payer: Priority Health Medicare |
$5,994.95
|
| Rate for Payer: Priority Health Tiered Network |
$9,038.72
|
| Rate for Payer: Railroad Medicare Medicare |
$5,994.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,423.04
|
| Rate for Payer: UHC Core |
$9,556.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,994.95
|
| Rate for Payer: UHC Exchange |
$7,804.81
|
| Rate for Payer: VA VA |
$5,994.95
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$6,514.41
|
|
|
Service Code
|
APR-DRG 2483
|
| Min. Negotiated Rate |
$6,204.20 |
| Max. Negotiated Rate |
$6,514.41 |
| Rate for Payer: BCBS Complete |
$6,514.41
|
| Rate for Payer: Mclaren Medicaid |
$6,204.20
|
| Rate for Payer: Meridian Medicaid |
$6,514.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,204.20
|
| Rate for Payer: UHC Medicaid |
$6,204.20
|
| Rate for Payer: UHCCP Medicaid |
$6,204.20
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$10,602.61
|
|
|
Service Code
|
APR-DRG 2484
|
| Min. Negotiated Rate |
$10,097.72 |
| Max. Negotiated Rate |
$10,602.61 |
| Rate for Payer: BCBS Complete |
$10,602.61
|
| Rate for Payer: Mclaren Medicaid |
$10,097.72
|
| Rate for Payer: Meridian Medicaid |
$10,602.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,097.72
|
| Rate for Payer: UHC Medicaid |
$10,097.72
|
| Rate for Payer: UHCCP Medicaid |
$10,097.72
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$3,805.57
|
|
|
Service Code
|
APR-DRG 2481
|
| Min. Negotiated Rate |
$3,624.35 |
| Max. Negotiated Rate |
$3,805.57 |
| Rate for Payer: BCBS Complete |
$3,805.57
|
| Rate for Payer: Mclaren Medicaid |
$3,624.35
|
| Rate for Payer: Meridian Medicaid |
$3,805.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,624.35
|
| Rate for Payer: UHC Medicaid |
$3,624.35
|
| Rate for Payer: UHCCP Medicaid |
$3,624.35
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$4,966.50
|
|
|
Service Code
|
APR-DRG 2482
|
| Min. Negotiated Rate |
$4,730.00 |
| Max. Negotiated Rate |
$4,966.50 |
| Rate for Payer: BCBS Complete |
$4,966.50
|
| Rate for Payer: Mclaren Medicaid |
$4,730.00
|
| Rate for Payer: Meridian Medicaid |
$4,966.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,730.00
|
| Rate for Payer: UHC Medicaid |
$4,730.00
|
| Rate for Payer: UHCCP Medicaid |
$4,730.00
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC
|
Facility
|
IP
|
$16,642.30
|
|
|
Service Code
|
MSDRG 372
|
| Min. Negotiated Rate |
$8,046.04 |
| Max. Negotiated Rate |
$16,642.30 |
| Rate for Payer: Aetna Medicare |
$8,808.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,586.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,586.90
|
| Rate for Payer: BCBS MAPPO |
$8,469.52
|
| Rate for Payer: BCBS Trust/PPO |
$15,868.28
|
| Rate for Payer: BCN Commercial |
$15,868.28
|
| Rate for Payer: BCN Medicare Advantage |
$8,469.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,469.52
|
| Rate for Payer: Mclaren Medicare |
$8,469.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,893.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,739.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,316.47
|
| Rate for Payer: Nomi Health Commercial |
$13,170.90
|
| Rate for Payer: PACE Medicare |
$8,046.04
|
| Rate for Payer: PACE SWMI |
$8,469.52
|
| Rate for Payer: PHP Medicare Advantage |
$8,469.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,460.70
|
| Rate for Payer: Priority Health Medicare |
$8,469.52
|
| Rate for Payer: Priority Health Tiered Network |
$13,168.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8,469.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,642.30
|
| Rate for Payer: UHC Core |
$13,923.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,469.52
|
| Rate for Payer: UHC Exchange |
$11,370.88
|
| Rate for Payer: VA VA |
$8,469.52
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC
|
Facility
|
IP
|
$30,563.83
|
|
|
Service Code
|
MSDRG 371
|
| Min. Negotiated Rate |
$13,567.83 |
| Max. Negotiated Rate |
$30,563.83 |
| Rate for Payer: Aetna Medicare |
$14,853.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,852.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,852.41
|
| Rate for Payer: BCBS MAPPO |
$14,281.93
|
| Rate for Payer: BCBS Trust/PPO |
$30,563.83
|
| Rate for Payer: BCN Commercial |
$30,563.83
|
| Rate for Payer: BCN Medicare Advantage |
$14,281.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,281.93
|
| Rate for Payer: Mclaren Medicare |
$14,281.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,996.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,424.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,710.12
|
| Rate for Payer: Nomi Health Commercial |
$22,872.99
|
| Rate for Payer: PACE Medicare |
$13,567.83
|
| Rate for Payer: PACE SWMI |
$14,281.93
|
| Rate for Payer: PHP Medicare Advantage |
$14,281.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,586.17
|
| Rate for Payer: Priority Health Medicare |
$14,281.93
|
| Rate for Payer: Priority Health Tiered Network |
$22,868.93
|
| Rate for Payer: Railroad Medicare Medicare |
$14,281.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,901.53
|
| Rate for Payer: UHC Core |
$24,179.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,281.93
|
| Rate for Payer: UHC Exchange |
$19,747.01
|
| Rate for Payer: VA VA |
$14,281.93
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,670.27
|
|
|
Service Code
|
MSDRG 373
|
| Min. Negotiated Rate |
$5,890.49 |
| Max. Negotiated Rate |
$13,670.27 |
| Rate for Payer: Aetna Medicare |
$6,448.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,750.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,750.65
|
| Rate for Payer: BCBS MAPPO |
$6,200.52
|
| Rate for Payer: BCBS Trust/PPO |
$13,670.27
|
| Rate for Payer: BCN Commercial |
$13,670.27
|
| Rate for Payer: BCN Medicare Advantage |
$6,200.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,200.52
|
| Rate for Payer: Mclaren Medicare |
$6,200.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,510.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,130.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,820.57
|
| Rate for Payer: Nomi Health Commercial |
$9,383.46
|
| Rate for Payer: PACE Medicare |
$5,890.49
|
| Rate for Payer: PACE SWMI |
$6,200.52
|
| Rate for Payer: PHP Medicare Advantage |
$6,200.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,727.24
|
| Rate for Payer: Priority Health Medicare |
$6,200.52
|
| Rate for Payer: Priority Health Tiered Network |
$9,381.79
|
| Rate for Payer: Railroad Medicare Medicare |
$6,200.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,856.62
|
| Rate for Payer: UHC Core |
$9,919.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,200.52
|
| Rate for Payer: UHC Exchange |
$8,101.05
|
| Rate for Payer: VA VA |
$6,200.52
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$59,872.98
|
|
|
Service Code
|
MSDRG 141
|
| Min. Negotiated Rate |
$16,563.29 |
| Max. Negotiated Rate |
$59,872.98 |
| Rate for Payer: PACE SWMI |
$17,435.04
|
| Rate for Payer: Aetna Medicare |
$18,132.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,793.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,793.80
|
| Rate for Payer: BCBS MAPPO |
$17,435.04
|
| Rate for Payer: BCBS Trust/PPO |
$59,872.98
|
| Rate for Payer: BCN Commercial |
$59,872.98
|
| Rate for Payer: BCN Medicare Advantage |
$17,435.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,435.04
|
| Rate for Payer: Mclaren Medicare |
$17,435.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,306.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,050.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,178.54
|
| Rate for Payer: Nomi Health Commercial |
$28,136.19
|
| Rate for Payer: PACE Medicare |
$16,563.29
|
| Rate for Payer: PHP Medicare Advantage |
$17,435.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35,164.00
|
| Rate for Payer: Priority Health Medicare |
$17,435.04
|
| Rate for Payer: Priority Health Tiered Network |
$28,131.20
|
| Rate for Payer: Railroad Medicare Medicare |
$17,435.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,551.93
|
| Rate for Payer: UHC Core |
$29,743.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,435.04
|
| Rate for Payer: UHC Exchange |
$24,290.91
|
| Rate for Payer: VA VA |
$17,435.04
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$78,444.89
|
|
|
Service Code
|
MSDRG 140
|
| Min. Negotiated Rate |
$31,865.10 |
| Max. Negotiated Rate |
$78,444.89 |
| Rate for Payer: Aetna Medicare |
$34,883.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41,927.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41,927.76
|
| Rate for Payer: BCBS MAPPO |
$33,542.21
|
| Rate for Payer: BCBS Trust/PPO |
$78,444.89
|
| Rate for Payer: BCN Commercial |
$78,444.89
|
| Rate for Payer: BCN Medicare Advantage |
$33,542.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33,542.21
|
| Rate for Payer: Mclaren Medicare |
$33,542.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35,219.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38,573.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$36,896.43
|
| Rate for Payer: Nomi Health Commercial |
$55,022.37
|
| Rate for Payer: PACE Medicare |
$31,865.10
|
| Rate for Payer: PACE SWMI |
$33,542.21
|
| Rate for Payer: PHP Medicare Advantage |
$33,542.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$68,765.76
|
| Rate for Payer: Priority Health Medicare |
$33,542.21
|
| Rate for Payer: Priority Health Tiered Network |
$55,012.60
|
| Rate for Payer: Railroad Medicare Medicare |
$33,542.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69,524.39
|
| Rate for Payer: UHC Core |
$58,165.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33,542.21
|
| Rate for Payer: UHC Exchange |
$47,502.65
|
| Rate for Payer: VA VA |
$33,542.21
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$44,276.23
|
|
|
Service Code
|
MSDRG 142
|
| Min. Negotiated Rate |
$12,270.53 |
| Max. Negotiated Rate |
$44,276.23 |
| Rate for Payer: Aetna Medicare |
$13,433.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,145.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,145.44
|
| Rate for Payer: BCBS MAPPO |
$12,916.35
|
| Rate for Payer: BCBS Trust/PPO |
$44,276.23
|
| Rate for Payer: BCN Commercial |
$44,276.23
|
| Rate for Payer: BCN Medicare Advantage |
$12,916.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,916.35
|
| Rate for Payer: Mclaren Medicare |
$12,916.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,562.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,853.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,207.99
|
| Rate for Payer: Nomi Health Commercial |
$20,593.56
|
| Rate for Payer: PACE Medicare |
$12,270.53
|
| Rate for Payer: PACE SWMI |
$12,916.35
|
| Rate for Payer: PHP Medicare Advantage |
$12,916.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,737.38
|
| Rate for Payer: Priority Health Medicare |
$12,916.35
|
| Rate for Payer: Priority Health Tiered Network |
$20,589.90
|
| Rate for Payer: Railroad Medicare Medicare |
$12,916.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,021.32
|
| Rate for Payer: UHC Core |
$21,770.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,916.35
|
| Rate for Payer: UHC Exchange |
$17,779.11
|
| Rate for Payer: VA VA |
$12,916.35
|
|
