|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$61,483.56
|
|
|
Service Code
|
APR-DRG 6134
|
| Min. Negotiated Rate |
$58,555.77 |
| Max. Negotiated Rate |
$61,483.56 |
| Rate for Payer: BCBS Complete |
$61,483.56
|
| Rate for Payer: Mclaren Medicaid |
$58,555.77
|
| Rate for Payer: Meridian Medicaid |
$61,483.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$58,555.77
|
| Rate for Payer: UHC Medicaid |
$58,555.77
|
| Rate for Payer: UHCCP Medicaid |
$58,555.77
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$17,643.88
|
|
|
Service Code
|
APR-DRG 6113
|
| Min. Negotiated Rate |
$16,803.70 |
| Max. Negotiated Rate |
$17,643.88 |
| Rate for Payer: BCBS Complete |
$17,643.88
|
| Rate for Payer: Mclaren Medicaid |
$16,803.70
|
| Rate for Payer: Meridian Medicaid |
$17,643.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,803.70
|
| Rate for Payer: UHC Medicaid |
$16,803.70
|
| Rate for Payer: UHCCP Medicaid |
$16,803.70
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$13,990.24
|
|
|
Service Code
|
APR-DRG 6112
|
| Min. Negotiated Rate |
$13,324.04 |
| Max. Negotiated Rate |
$13,990.24 |
| Rate for Payer: BCBS Complete |
$13,990.24
|
| Rate for Payer: Mclaren Medicaid |
$13,324.04
|
| Rate for Payer: Meridian Medicaid |
$13,990.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,324.04
|
| Rate for Payer: UHC Medicaid |
$13,324.04
|
| Rate for Payer: UHCCP Medicaid |
$13,324.04
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$36,050.82
|
|
|
Service Code
|
APR-DRG 6114
|
| Min. Negotiated Rate |
$34,334.12 |
| Max. Negotiated Rate |
$36,050.82 |
| Rate for Payer: BCBS Complete |
$36,050.82
|
| Rate for Payer: Mclaren Medicaid |
$34,334.12
|
| Rate for Payer: Meridian Medicaid |
$36,050.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$34,334.12
|
| Rate for Payer: UHC Medicaid |
$34,334.12
|
| Rate for Payer: UHCCP Medicaid |
$34,334.12
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$4,975.10
|
|
|
Service Code
|
APR-DRG 6111
|
| Min. Negotiated Rate |
$4,738.19 |
| Max. Negotiated Rate |
$4,975.10 |
| Rate for Payer: BCBS Complete |
$4,975.10
|
| Rate for Payer: Mclaren Medicaid |
$4,738.19
|
| Rate for Payer: Meridian Medicaid |
$4,975.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,738.19
|
| Rate for Payer: UHC Medicaid |
$4,738.19
|
| Rate for Payer: UHCCP Medicaid |
$4,738.19
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$20,335.52
|
|
|
Service Code
|
APR-DRG 6143
|
| Min. Negotiated Rate |
$19,367.17 |
| Max. Negotiated Rate |
$20,335.52 |
| Rate for Payer: BCBS Complete |
$20,335.52
|
| Rate for Payer: Mclaren Medicaid |
$19,367.17
|
| Rate for Payer: Meridian Medicaid |
$20,335.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,367.17
|
| Rate for Payer: UHC Medicaid |
$19,367.17
|
| Rate for Payer: UHCCP Medicaid |
$19,367.17
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$11,529.06
|
|
|
Service Code
|
APR-DRG 6142
|
| Min. Negotiated Rate |
$10,980.06 |
| Max. Negotiated Rate |
$11,529.06 |
| Rate for Payer: BCBS Complete |
$11,529.06
|
| Rate for Payer: Mclaren Medicaid |
$10,980.06
|
| Rate for Payer: Meridian Medicaid |
$11,529.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,980.06
|
| Rate for Payer: UHC Medicaid |
$10,980.06
|
| Rate for Payer: UHCCP Medicaid |
$10,980.06
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$28,349.69
|
|
|
Service Code
|
APR-DRG 6144
|
| Min. Negotiated Rate |
$26,999.70 |
| Max. Negotiated Rate |
$28,349.69 |
| Rate for Payer: BCBS Complete |
$28,349.69
|
| Rate for Payer: Mclaren Medicaid |
$26,999.70
|
| Rate for Payer: Meridian Medicaid |
$28,349.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,999.70
|
| Rate for Payer: UHC Medicaid |
$26,999.70
|
| Rate for Payer: UHCCP Medicaid |
$26,999.70
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$4,290.00
|
|
|
Service Code
|
APR-DRG 6141
|
| Min. Negotiated Rate |
$4,085.72 |
| Max. Negotiated Rate |
$4,290.00 |
| Rate for Payer: BCBS Complete |
$4,290.00
|
| Rate for Payer: Mclaren Medicaid |
$4,085.72
|
| Rate for Payer: Meridian Medicaid |
$4,290.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,085.72
|
| Rate for Payer: UHC Medicaid |
$4,085.72
|
| Rate for Payer: UHCCP Medicaid |
$4,085.72
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$35,412.17
|
|
|
Service Code
|
APR-DRG 6123
|
| Min. Negotiated Rate |
$33,725.87 |
| Max. Negotiated Rate |
$35,412.17 |
| Rate for Payer: BCBS Complete |
$35,412.17
|
| Rate for Payer: Mclaren Medicaid |
$33,725.87
|
| Rate for Payer: Meridian Medicaid |
$35,412.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$33,725.87
|
| Rate for Payer: UHC Medicaid |
$33,725.87
|
| Rate for Payer: UHCCP Medicaid |
$33,725.87
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$11,201.14
|
|
|
Service Code
|
APR-DRG 6121
|
| Min. Negotiated Rate |
$10,667.75 |
| Max. Negotiated Rate |
$11,201.14 |
| Rate for Payer: BCBS Complete |
$11,201.14
|
| Rate for Payer: Mclaren Medicaid |
$10,667.75
|
| Rate for Payer: Meridian Medicaid |
$11,201.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,667.75
|
| Rate for Payer: UHC Medicaid |
$10,667.75
|
| Rate for Payer: UHCCP Medicaid |
$10,667.75
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$54,798.31
|
|
|
Service Code
|
APR-DRG 6124
|
| Min. Negotiated Rate |
$52,188.86 |
| Max. Negotiated Rate |
$54,798.31 |
| Rate for Payer: BCBS Complete |
$54,798.31
|
| Rate for Payer: Mclaren Medicaid |
$52,188.86
|
| Rate for Payer: Meridian Medicaid |
$54,798.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$52,188.86
|
| Rate for Payer: UHC Medicaid |
$52,188.86
|
| Rate for Payer: UHCCP Medicaid |
$52,188.86
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$16,975.99
|
|
|
Service Code
|
APR-DRG 6122
|
| Min. Negotiated Rate |
$16,167.61 |
| Max. Negotiated Rate |
$16,975.99 |
| Rate for Payer: BCBS Complete |
$16,975.99
|
| Rate for Payer: Mclaren Medicaid |
$16,167.61
|
| Rate for Payer: Meridian Medicaid |
$16,975.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,167.61
|
| Rate for Payer: UHC Medicaid |
$16,167.61
|
| Rate for Payer: UHCCP Medicaid |
$16,167.61
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$26,395.88
|
|
|
Service Code
|
APR-DRG 6091
|
| Min. Negotiated Rate |
$25,138.93 |
| Max. Negotiated Rate |
$26,395.88 |
| Rate for Payer: BCBS Complete |
$26,395.88
|
| Rate for Payer: Mclaren Medicaid |
$25,138.93
|
| Rate for Payer: Meridian Medicaid |
$26,395.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,138.93
|
| Rate for Payer: UHC Medicaid |
$25,138.93
|
| Rate for Payer: UHCCP Medicaid |
$25,138.93
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$156,668.56
|
|
|
Service Code
|
APR-DRG 6094
|
| Min. Negotiated Rate |
$149,208.15 |
| Max. Negotiated Rate |
$156,668.56 |
| Rate for Payer: BCBS Complete |
$156,668.56
|
| Rate for Payer: Mclaren Medicaid |
$149,208.15
|
| Rate for Payer: Meridian Medicaid |
$156,668.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$149,208.15
|
| Rate for Payer: UHC Medicaid |
$149,208.15
|
| Rate for Payer: UHCCP Medicaid |
$149,208.15
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$31,987.27
|
|
|
Service Code
|
APR-DRG 6092
|
| Min. Negotiated Rate |
$30,464.07 |
| Max. Negotiated Rate |
$31,987.27 |
| Rate for Payer: BCBS Complete |
$31,987.27
|
| Rate for Payer: Mclaren Medicaid |
$30,464.07
|
| Rate for Payer: Meridian Medicaid |
$31,987.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$30,464.07
|
| Rate for Payer: UHC Medicaid |
$30,464.07
|
| Rate for Payer: UHCCP Medicaid |
$30,464.07
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$50,168.91
|
|
|
Service Code
|
APR-DRG 6093
|
| Min. Negotiated Rate |
$47,779.91 |
| Max. Negotiated Rate |
$50,168.91 |
| Rate for Payer: BCBS Complete |
$50,168.91
|
| Rate for Payer: Mclaren Medicaid |
$47,779.91
|
| Rate for Payer: Meridian Medicaid |
$50,168.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$47,779.91
|
| Rate for Payer: UHC Medicaid |
$47,779.91
|
| Rate for Payer: UHCCP Medicaid |
$47,779.91
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$117,270.23
|
|
|
Service Code
|
APR-DRG 5883
|
| Min. Negotiated Rate |
$111,685.94 |
| Max. Negotiated Rate |
$117,270.23 |
| Rate for Payer: BCBS Complete |
$117,270.23
|
| Rate for Payer: Mclaren Medicaid |
$111,685.94
|
| Rate for Payer: Meridian Medicaid |
$117,270.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$111,685.94
|
| Rate for Payer: UHC Medicaid |
$111,685.94
|
| Rate for Payer: UHCCP Medicaid |
$111,685.94
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$108,146.17
|
|
|
Service Code
|
APR-DRG 5882
|
| Min. Negotiated Rate |
$102,996.35 |
| Max. Negotiated Rate |
$108,146.17 |
| Rate for Payer: BCBS Complete |
$108,146.17
|
| Rate for Payer: Mclaren Medicaid |
$102,996.35
|
| Rate for Payer: Meridian Medicaid |
$108,146.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$102,996.35
|
| Rate for Payer: UHC Medicaid |
$102,996.35
|
| Rate for Payer: UHCCP Medicaid |
$102,996.35
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$212,739.59
|
|
|
Service Code
|
APR-DRG 5884
|
| Min. Negotiated Rate |
$202,609.13 |
| Max. Negotiated Rate |
$212,739.59 |
| Rate for Payer: BCBS Complete |
$212,739.59
|
| Rate for Payer: Mclaren Medicaid |
$202,609.13
|
| Rate for Payer: Meridian Medicaid |
$212,739.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$202,609.13
|
| Rate for Payer: UHC Medicaid |
$202,609.13
|
| Rate for Payer: UHCCP Medicaid |
$202,609.13
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$101,251.66
|
|
|
Service Code
|
APR-DRG 5881
|
| Min. Negotiated Rate |
$96,430.15 |
| Max. Negotiated Rate |
$101,251.66 |
| Rate for Payer: BCBS Complete |
$101,251.66
|
| Rate for Payer: Mclaren Medicaid |
$96,430.15
|
| Rate for Payer: Meridian Medicaid |
$101,251.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$96,430.15
|
| Rate for Payer: UHC Medicaid |
$96,430.15
|
| Rate for Payer: UHCCP Medicaid |
$96,430.15
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLE
|
Facility
|
IP
|
$959.13
|
|
|
Service Code
|
APR-DRG 6261
|
| Min. Negotiated Rate |
$913.46 |
| Max. Negotiated Rate |
$959.13 |
| Rate for Payer: BCBS Complete |
$959.13
|
| Rate for Payer: Mclaren Medicaid |
$913.46
|
| Rate for Payer: Meridian Medicaid |
$959.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$913.46
|
| Rate for Payer: UHC Medicaid |
$913.46
|
| Rate for Payer: UHCCP Medicaid |
$913.46
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLE
|
Facility
|
IP
|
$3,756.83
|
|
|
Service Code
|
APR-DRG 6263
|
| Min. Negotiated Rate |
$3,577.94 |
| Max. Negotiated Rate |
$3,756.83 |
| Rate for Payer: BCBS Complete |
$3,756.83
|
| Rate for Payer: Mclaren Medicaid |
$3,577.94
|
| Rate for Payer: Meridian Medicaid |
$3,756.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,577.94
|
| Rate for Payer: UHC Medicaid |
$3,577.94
|
| Rate for Payer: UHCCP Medicaid |
$3,577.94
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLE
|
Facility
|
IP
|
$1,465.93
|
|
|
Service Code
|
APR-DRG 6262
|
| Min. Negotiated Rate |
$1,396.12 |
| Max. Negotiated Rate |
$1,465.93 |
| Rate for Payer: BCBS Complete |
$1,465.93
|
| Rate for Payer: Mclaren Medicaid |
$1,396.12
|
| Rate for Payer: Meridian Medicaid |
$1,465.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,396.12
|
| Rate for Payer: UHC Medicaid |
$1,396.12
|
| Rate for Payer: UHCCP Medicaid |
$1,396.12
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLE
|
Facility
|
IP
|
$6,267.89
|
|
|
Service Code
|
APR-DRG 6264
|
| Min. Negotiated Rate |
$5,969.42 |
| Max. Negotiated Rate |
$6,267.89 |
| Rate for Payer: BCBS Complete |
$6,267.89
|
| Rate for Payer: Mclaren Medicaid |
$5,969.42
|
| Rate for Payer: Meridian Medicaid |
$6,267.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,969.42
|
| Rate for Payer: UHC Medicaid |
$5,969.42
|
| Rate for Payer: UHCCP Medicaid |
$5,969.42
|
|