|
MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$13,018.84
|
|
|
Service Code
|
MSDRG 508
|
| Min. Negotiated Rate |
$9,894.32 |
| Max. Negotiated Rate |
$13,018.84 |
| Rate for Payer: Aetna Medicare |
$10,831.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,018.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,018.84
|
| Rate for Payer: BCBS MAPPO |
$10,415.07
|
| Rate for Payer: BCN Medicare Advantage |
$10,415.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,415.07
|
| Rate for Payer: Mclaren Medicare |
$10,415.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,935.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,977.33
|
| Rate for Payer: PACE Medicare |
$9,894.32
|
| Rate for Payer: PACE SWMI |
$10,415.07
|
| Rate for Payer: PHP Medicare Advantage |
$10,415.07
|
| Rate for Payer: Priority Health Medicare |
$10,415.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10,415.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,415.07
|
| Rate for Payer: UHC Medicare Advantage |
$10,415.07
|
| Rate for Payer: VA VA |
$10,415.07
|
|
|
MS-DRG 42.00: MAJOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$20,960.99
|
|
|
Service Code
|
MSDRG 595
|
| Min. Negotiated Rate |
$15,930.35 |
| Max. Negotiated Rate |
$20,960.99 |
| Rate for Payer: Aetna Medicare |
$17,439.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,960.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,960.99
|
| Rate for Payer: BCBS MAPPO |
$16,768.79
|
| Rate for Payer: BCN Medicare Advantage |
$16,768.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,768.79
|
| Rate for Payer: Mclaren Medicare |
$16,768.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,607.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,284.11
|
| Rate for Payer: PACE Medicare |
$15,930.35
|
| Rate for Payer: PACE SWMI |
$16,768.79
|
| Rate for Payer: PHP Medicare Advantage |
$16,768.79
|
| Rate for Payer: Priority Health Medicare |
$16,768.79
|
| Rate for Payer: Railroad Medicare Medicare |
$16,768.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,768.79
|
| Rate for Payer: UHC Medicare Advantage |
$16,768.79
|
| Rate for Payer: VA VA |
$16,768.79
|
|
|
MS-DRG 42.00: MAJOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$11,000.76
|
|
|
Service Code
|
MSDRG 596
|
| Min. Negotiated Rate |
$8,360.58 |
| Max. Negotiated Rate |
$11,000.76 |
| Rate for Payer: Aetna Medicare |
$9,152.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,000.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,000.76
|
| Rate for Payer: BCBS MAPPO |
$8,800.61
|
| Rate for Payer: BCN Medicare Advantage |
$8,800.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,800.61
|
| Rate for Payer: Mclaren Medicare |
$8,800.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,240.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,120.70
|
| Rate for Payer: PACE Medicare |
$8,360.58
|
| Rate for Payer: PACE SWMI |
$8,800.61
|
| Rate for Payer: PHP Medicare Advantage |
$8,800.61
|
| Rate for Payer: Priority Health Medicare |
$8,800.61
|
| Rate for Payer: Railroad Medicare Medicare |
$8,800.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,800.61
|
| Rate for Payer: UHC Medicare Advantage |
$8,800.61
|
| Rate for Payer: VA VA |
$8,800.61
|
|
|
MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$23,355.67
|
|
|
Service Code
|
MSDRG 330
|
| Min. Negotiated Rate |
$17,750.31 |
| Max. Negotiated Rate |
$23,355.67 |
| Rate for Payer: Aetna Medicare |
$19,431.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,355.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,355.67
|
| Rate for Payer: BCBS MAPPO |
$18,684.54
|
| Rate for Payer: BCN Medicare Advantage |
$18,684.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,684.54
|
| Rate for Payer: Mclaren Medicare |
$18,684.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,618.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,487.22
|
| Rate for Payer: PACE Medicare |
$17,750.31
|
| Rate for Payer: PACE SWMI |
$18,684.54
|
| Rate for Payer: PHP Medicare Advantage |
$18,684.54
|
| Rate for Payer: Priority Health Medicare |
$18,684.54
|
| Rate for Payer: Railroad Medicare Medicare |
$18,684.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,684.54
|
| Rate for Payer: UHC Medicare Advantage |
$18,684.54
|
| Rate for Payer: VA VA |
$18,684.54
|
|
|
MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$44,819.25
|
|
|
Service Code
|
MSDRG 329
|
| Min. Negotiated Rate |
$34,062.63 |
| Max. Negotiated Rate |
$44,819.25 |
| Rate for Payer: Aetna Medicare |
$37,289.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44,819.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44,819.25
|
| Rate for Payer: BCBS MAPPO |
$35,855.40
|
| Rate for Payer: BCN Medicare Advantage |
$35,855.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,855.40
|
| Rate for Payer: Mclaren Medicare |
$35,855.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37,648.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41,233.71
|
| Rate for Payer: PACE Medicare |
$34,062.63
|
| Rate for Payer: PACE SWMI |
$35,855.40
|
| Rate for Payer: PHP Medicare Advantage |
$35,855.40
|
| Rate for Payer: Priority Health Medicare |
$35,855.40
|
| Rate for Payer: Railroad Medicare Medicare |
$35,855.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$35,855.40
|
| Rate for Payer: UHC Medicare Advantage |
$35,855.40
|
| Rate for Payer: VA VA |
$35,855.40
|
|
|
MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,490.42
|
|
|
Service Code
|
MSDRG 331
|
| Min. Negotiated Rate |
$12,532.72 |
| Max. Negotiated Rate |
$16,490.42 |
| Rate for Payer: Aetna Medicare |
$13,720.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,490.42
|
| Rate for Payer: BCBS MAPPO |
$13,192.34
|
| Rate for Payer: BCN Medicare Advantage |
$13,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,192.34
|
| Rate for Payer: Mclaren Medicare |
$13,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,851.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,171.19
|
| Rate for Payer: PACE Medicare |
$12,532.72
|
| Rate for Payer: PACE SWMI |
$13,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$13,192.34
|
| Rate for Payer: Priority Health Medicare |
$13,192.34
|
| Rate for Payer: Railroad Medicare Medicare |
$13,192.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,192.34
|
| Rate for Payer: UHC Medicare Advantage |
$13,192.34
|
| Rate for Payer: VA VA |
$13,192.34
|
|
|
MS-DRG 42.00: MAJOR THUMB OR JOINT PROCEDURES
|
Facility
|
IP
|
$15,027.25
|
|
|
Service Code
|
MSDRG 506
|
| Min. Negotiated Rate |
$11,420.71 |
| Max. Negotiated Rate |
$15,027.25 |
| Rate for Payer: Aetna Medicare |
$12,502.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,027.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,027.25
|
| Rate for Payer: BCBS MAPPO |
$12,021.80
|
| Rate for Payer: BCN Medicare Advantage |
$12,021.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,021.80
|
| Rate for Payer: Mclaren Medicare |
$12,021.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,622.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,825.07
|
| Rate for Payer: PACE Medicare |
$11,420.71
|
| Rate for Payer: PACE SWMI |
$12,021.80
|
| Rate for Payer: PHP Medicare Advantage |
$12,021.80
|
| Rate for Payer: Priority Health Medicare |
$12,021.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12,021.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,021.80
|
| Rate for Payer: UHC Medicare Advantage |
$12,021.80
|
| Rate for Payer: VA VA |
$12,021.80
|
|
|
MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$11,280.11
|
|
|
Service Code
|
MSDRG 755
|
| Min. Negotiated Rate |
$8,572.89 |
| Max. Negotiated Rate |
$11,280.11 |
| Rate for Payer: Aetna Medicare |
$9,385.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,280.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,280.11
|
| Rate for Payer: BCBS MAPPO |
$9,024.09
|
| Rate for Payer: BCN Medicare Advantage |
$9,024.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,024.09
|
| Rate for Payer: Mclaren Medicare |
$9,024.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,475.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,377.70
|
| Rate for Payer: PACE Medicare |
$8,572.89
|
| Rate for Payer: PACE SWMI |
$9,024.09
|
| Rate for Payer: PHP Medicare Advantage |
$9,024.09
|
| Rate for Payer: Priority Health Medicare |
$9,024.09
|
| Rate for Payer: Railroad Medicare Medicare |
$9,024.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,024.09
|
| Rate for Payer: UHC Medicare Advantage |
$9,024.09
|
| Rate for Payer: VA VA |
$9,024.09
|
|
|
MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$18,015.29
|
|
|
Service Code
|
MSDRG 754
|
| Min. Negotiated Rate |
$13,691.62 |
| Max. Negotiated Rate |
$18,015.29 |
| Rate for Payer: Aetna Medicare |
$14,988.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,015.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,015.29
|
| Rate for Payer: BCBS MAPPO |
$14,412.23
|
| Rate for Payer: BCN Medicare Advantage |
$14,412.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,412.23
|
| Rate for Payer: Mclaren Medicare |
$14,412.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,132.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,574.06
|
| Rate for Payer: PACE Medicare |
$13,691.62
|
| Rate for Payer: PACE SWMI |
$14,412.23
|
| Rate for Payer: PHP Medicare Advantage |
$14,412.23
|
| Rate for Payer: Priority Health Medicare |
$14,412.23
|
| Rate for Payer: Railroad Medicare Medicare |
$14,412.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,412.23
|
| Rate for Payer: UHC Medicare Advantage |
$14,412.23
|
| Rate for Payer: VA VA |
$14,412.23
|
|
|
MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$9,786.08
|
|
|
Service Code
|
MSDRG 756
|
| Min. Negotiated Rate |
$7,437.42 |
| Max. Negotiated Rate |
$9,786.08 |
| Rate for Payer: Aetna Medicare |
$8,142.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,786.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,786.08
|
| Rate for Payer: BCBS MAPPO |
$7,828.86
|
| Rate for Payer: BCN Medicare Advantage |
$7,828.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,828.86
|
| Rate for Payer: Mclaren Medicare |
$7,828.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,220.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,003.19
|
| Rate for Payer: PACE Medicare |
$7,437.42
|
| Rate for Payer: PACE SWMI |
$7,828.86
|
| Rate for Payer: PHP Medicare Advantage |
$7,828.86
|
| Rate for Payer: Priority Health Medicare |
$7,828.86
|
| Rate for Payer: Railroad Medicare Medicare |
$7,828.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,828.86
|
| Rate for Payer: UHC Medicare Advantage |
$7,828.86
|
| Rate for Payer: VA VA |
$7,828.86
|
|
|
MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$11,403.41
|
|
|
Service Code
|
MSDRG 723
|
| Min. Negotiated Rate |
$8,666.59 |
| Max. Negotiated Rate |
$11,403.41 |
| Rate for Payer: Aetna Medicare |
$9,487.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,403.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,403.41
|
| Rate for Payer: BCBS MAPPO |
$9,122.73
|
| Rate for Payer: BCN Medicare Advantage |
$9,122.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,122.73
|
| Rate for Payer: Mclaren Medicare |
$9,122.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,578.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,491.14
|
| Rate for Payer: PACE Medicare |
$8,666.59
|
| Rate for Payer: PACE SWMI |
$9,122.73
|
| Rate for Payer: PHP Medicare Advantage |
$9,122.73
|
| Rate for Payer: Priority Health Medicare |
$9,122.73
|
| Rate for Payer: Railroad Medicare Medicare |
$9,122.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,122.73
|
| Rate for Payer: UHC Medicare Advantage |
$9,122.73
|
| Rate for Payer: VA VA |
$9,122.73
|
|
|
MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$17,240.84
|
|
|
Service Code
|
MSDRG 722
|
| Min. Negotiated Rate |
$13,103.04 |
| Max. Negotiated Rate |
$17,240.84 |
| Rate for Payer: Aetna Medicare |
$14,344.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,240.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,240.84
|
| Rate for Payer: BCBS MAPPO |
$13,792.67
|
| Rate for Payer: BCN Medicare Advantage |
$13,792.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,792.67
|
| Rate for Payer: Mclaren Medicare |
$13,792.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,482.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,861.57
|
| Rate for Payer: PACE Medicare |
$13,103.04
|
| Rate for Payer: PACE SWMI |
$13,792.67
|
| Rate for Payer: PHP Medicare Advantage |
$13,792.67
|
| Rate for Payer: Priority Health Medicare |
$13,792.67
|
| Rate for Payer: Railroad Medicare Medicare |
$13,792.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,792.67
|
| Rate for Payer: UHC Medicare Advantage |
$13,792.67
|
| Rate for Payer: VA VA |
$13,792.67
|
|
|
MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$7,605.25
|
|
|
Service Code
|
MSDRG 724
|
| Min. Negotiated Rate |
$5,779.99 |
| Max. Negotiated Rate |
$7,605.25 |
| Rate for Payer: Aetna Medicare |
$6,327.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,605.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,605.25
|
| Rate for Payer: BCBS MAPPO |
$6,084.20
|
| Rate for Payer: BCN Medicare Advantage |
$6,084.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,084.20
|
| Rate for Payer: Mclaren Medicare |
$6,084.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,388.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,996.83
|
| Rate for Payer: PACE Medicare |
$5,779.99
|
| Rate for Payer: PACE SWMI |
$6,084.20
|
| Rate for Payer: PHP Medicare Advantage |
$6,084.20
|
| Rate for Payer: Priority Health Medicare |
$6,084.20
|
| Rate for Payer: Railroad Medicare Medicare |
$6,084.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,084.20
|
| Rate for Payer: UHC Medicare Advantage |
$6,084.20
|
| Rate for Payer: VA VA |
$6,084.20
|
|
|
MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC
|
Facility
|
IP
|
$11,449.64
|
|
|
Service Code
|
MSDRG 436
|
| Min. Negotiated Rate |
$8,701.72 |
| Max. Negotiated Rate |
$11,449.64 |
| Rate for Payer: Aetna Medicare |
$9,526.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,449.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,449.64
|
| Rate for Payer: BCBS MAPPO |
$9,159.71
|
| Rate for Payer: BCN Medicare Advantage |
$9,159.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,159.71
|
| Rate for Payer: Mclaren Medicare |
$9,159.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,617.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,533.67
|
| Rate for Payer: PACE Medicare |
$8,701.72
|
| Rate for Payer: PACE SWMI |
$9,159.71
|
| Rate for Payer: PHP Medicare Advantage |
$9,159.71
|
| Rate for Payer: Priority Health Medicare |
$9,159.71
|
| Rate for Payer: Railroad Medicare Medicare |
$9,159.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,159.71
|
| Rate for Payer: UHC Medicare Advantage |
$9,159.71
|
| Rate for Payer: VA VA |
$9,159.71
|
|
|
MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC
|
Facility
|
IP
|
$18,162.67
|
|
|
Service Code
|
MSDRG 435
|
| Min. Negotiated Rate |
$13,803.63 |
| Max. Negotiated Rate |
$18,162.67 |
| Rate for Payer: Aetna Medicare |
$15,111.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,162.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,162.67
|
| Rate for Payer: BCBS MAPPO |
$14,530.14
|
| Rate for Payer: BCN Medicare Advantage |
$14,530.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,530.14
|
| Rate for Payer: Mclaren Medicare |
$14,530.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,256.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,709.66
|
| Rate for Payer: PACE Medicare |
$13,803.63
|
| Rate for Payer: PACE SWMI |
$14,530.14
|
| Rate for Payer: PHP Medicare Advantage |
$14,530.14
|
| Rate for Payer: Priority Health Medicare |
$14,530.14
|
| Rate for Payer: Railroad Medicare Medicare |
$14,530.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,530.14
|
| Rate for Payer: UHC Medicare Advantage |
$14,530.14
|
| Rate for Payer: VA VA |
$14,530.14
|
|
|
MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC
|
Facility
|
IP
|
$8,150.44
|
|
|
Service Code
|
MSDRG 437
|
| Min. Negotiated Rate |
$6,194.33 |
| Max. Negotiated Rate |
$8,150.44 |
| Rate for Payer: Aetna Medicare |
$6,781.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,150.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,150.44
|
| Rate for Payer: BCBS MAPPO |
$6,520.35
|
| Rate for Payer: BCN Medicare Advantage |
$6,520.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,520.35
|
| Rate for Payer: Mclaren Medicare |
$6,520.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,846.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,498.40
|
| Rate for Payer: PACE Medicare |
$6,194.33
|
| Rate for Payer: PACE SWMI |
$6,520.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,520.35
|
| Rate for Payer: Priority Health Medicare |
$6,520.35
|
| Rate for Payer: Railroad Medicare Medicare |
$6,520.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,520.35
|
| Rate for Payer: UHC Medicare Advantage |
$6,520.35
|
| Rate for Payer: VA VA |
$6,520.35
|
|
|
MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH CC
|
Facility
|
IP
|
$10,979.58
|
|
|
Service Code
|
MSDRG 598
|
| Min. Negotiated Rate |
$8,344.48 |
| Max. Negotiated Rate |
$10,979.58 |
| Rate for Payer: Aetna Medicare |
$9,135.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,979.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,979.58
|
| Rate for Payer: BCBS MAPPO |
$8,783.66
|
| Rate for Payer: BCN Medicare Advantage |
$8,783.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,783.66
|
| Rate for Payer: Mclaren Medicare |
$8,783.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,222.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,101.21
|
| Rate for Payer: PACE Medicare |
$8,344.48
|
| Rate for Payer: PACE SWMI |
$8,783.66
|
| Rate for Payer: PHP Medicare Advantage |
$8,783.66
|
| Rate for Payer: Priority Health Medicare |
$8,783.66
|
| Rate for Payer: Railroad Medicare Medicare |
$8,783.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,783.66
|
| Rate for Payer: UHC Medicare Advantage |
$8,783.66
|
| Rate for Payer: VA VA |
$8,783.66
|
|
|
MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH MCC
|
Facility
|
IP
|
$17,508.62
|
|
|
Service Code
|
MSDRG 597
|
| Min. Negotiated Rate |
$13,306.56 |
| Max. Negotiated Rate |
$17,508.62 |
| Rate for Payer: Aetna Medicare |
$14,567.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,508.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,508.62
|
| Rate for Payer: BCBS MAPPO |
$14,006.90
|
| Rate for Payer: BCN Medicare Advantage |
$14,006.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,006.90
|
| Rate for Payer: Mclaren Medicare |
$14,006.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,707.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,107.93
|
| Rate for Payer: PACE Medicare |
$13,306.56
|
| Rate for Payer: PACE SWMI |
$14,006.90
|
| Rate for Payer: PHP Medicare Advantage |
$14,006.90
|
| Rate for Payer: Priority Health Medicare |
$14,006.90
|
| Rate for Payer: Railroad Medicare Medicare |
$14,006.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,006.90
|
| Rate for Payer: UHC Medicare Advantage |
$14,006.90
|
| Rate for Payer: VA VA |
$14,006.90
|
|
|
MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$8,821.83
|
|
|
Service Code
|
MSDRG 599
|
| Min. Negotiated Rate |
$6,704.59 |
| Max. Negotiated Rate |
$8,821.83 |
| Rate for Payer: Aetna Medicare |
$7,339.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,821.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,821.83
|
| Rate for Payer: BCBS MAPPO |
$7,057.46
|
| Rate for Payer: BCN Medicare Advantage |
$7,057.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,057.46
|
| Rate for Payer: Mclaren Medicare |
$7,057.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,410.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,116.08
|
| Rate for Payer: PACE Medicare |
$6,704.59
|
| Rate for Payer: PACE SWMI |
$7,057.46
|
| Rate for Payer: PHP Medicare Advantage |
$7,057.46
|
| Rate for Payer: Priority Health Medicare |
$7,057.46
|
| Rate for Payer: Railroad Medicare Medicare |
$7,057.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,057.46
|
| Rate for Payer: UHC Medicare Advantage |
$7,057.46
|
| Rate for Payer: VA VA |
$7,057.46
|
|
|
MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$17,455.62
|
|
|
Service Code
|
MSDRG 582
|
| Min. Negotiated Rate |
$13,266.27 |
| Max. Negotiated Rate |
$17,455.62 |
| Rate for Payer: Aetna Medicare |
$14,523.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,455.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,455.62
|
| Rate for Payer: BCBS MAPPO |
$13,964.50
|
| Rate for Payer: BCN Medicare Advantage |
$13,964.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,964.50
|
| Rate for Payer: Mclaren Medicare |
$13,964.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,662.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,059.17
|
| Rate for Payer: PACE Medicare |
$13,266.27
|
| Rate for Payer: PACE SWMI |
$13,964.50
|
| Rate for Payer: PHP Medicare Advantage |
$13,964.50
|
| Rate for Payer: Priority Health Medicare |
$13,964.50
|
| Rate for Payer: Railroad Medicare Medicare |
$13,964.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,964.50
|
| Rate for Payer: UHC Medicare Advantage |
$13,964.50
|
| Rate for Payer: VA VA |
$13,964.50
|
|
|
MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$16,410.50
|
|
|
Service Code
|
MSDRG 583
|
| Min. Negotiated Rate |
$12,471.98 |
| Max. Negotiated Rate |
$16,410.50 |
| Rate for Payer: Aetna Medicare |
$13,653.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,410.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,410.50
|
| Rate for Payer: BCBS MAPPO |
$13,128.40
|
| Rate for Payer: BCN Medicare Advantage |
$13,128.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,128.40
|
| Rate for Payer: Mclaren Medicare |
$13,128.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,784.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,097.66
|
| Rate for Payer: PACE Medicare |
$12,471.98
|
| Rate for Payer: PACE SWMI |
$13,128.40
|
| Rate for Payer: PHP Medicare Advantage |
$13,128.40
|
| Rate for Payer: Priority Health Medicare |
$13,128.40
|
| Rate for Payer: Railroad Medicare Medicare |
$13,128.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,128.40
|
| Rate for Payer: UHC Medicare Advantage |
$13,128.40
|
| Rate for Payer: VA VA |
$13,128.40
|
|
|
MS-DRG 42.00: MEDICAL BACK PROBLEMS WITH MCC
|
Facility
|
IP
|
$17,024.10
|
|
|
Service Code
|
MSDRG 551
|
| Min. Negotiated Rate |
$12,938.32 |
| Max. Negotiated Rate |
$17,024.10 |
| Rate for Payer: Aetna Medicare |
$14,164.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,024.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,024.10
|
| Rate for Payer: BCBS MAPPO |
$13,619.28
|
| Rate for Payer: BCN Medicare Advantage |
$13,619.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,619.28
|
| Rate for Payer: Mclaren Medicare |
$13,619.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,300.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,662.17
|
| Rate for Payer: PACE Medicare |
$12,938.32
|
| Rate for Payer: PACE SWMI |
$13,619.28
|
| Rate for Payer: PHP Medicare Advantage |
$13,619.28
|
| Rate for Payer: Priority Health Medicare |
$13,619.28
|
| Rate for Payer: Railroad Medicare Medicare |
$13,619.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,619.28
|
| Rate for Payer: UHC Medicare Advantage |
$13,619.28
|
| Rate for Payer: VA VA |
$13,619.28
|
|
|
MS-DRG 42.00: MEDICAL BACK PROBLEMS WITHOUT MCC
|
Facility
|
IP
|
$9,870.85
|
|
|
Service Code
|
MSDRG 552
|
| Min. Negotiated Rate |
$7,501.85 |
| Max. Negotiated Rate |
$9,870.85 |
| Rate for Payer: Aetna Medicare |
$8,212.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,870.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,870.85
|
| Rate for Payer: BCBS MAPPO |
$7,896.68
|
| Rate for Payer: BCN Medicare Advantage |
$7,896.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,896.68
|
| Rate for Payer: Mclaren Medicare |
$7,896.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,291.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,081.18
|
| Rate for Payer: PACE Medicare |
$7,501.85
|
| Rate for Payer: PACE SWMI |
$7,896.68
|
| Rate for Payer: PHP Medicare Advantage |
$7,896.68
|
| Rate for Payer: Priority Health Medicare |
$7,896.68
|
| Rate for Payer: Railroad Medicare Medicare |
$7,896.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,896.68
|
| Rate for Payer: UHC Medicare Advantage |
$7,896.68
|
| Rate for Payer: VA VA |
$7,896.68
|
|
|
MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC
|
Facility
|
IP
|
$10,080.84
|
|
|
Service Code
|
MSDRG 760
|
| Min. Negotiated Rate |
$7,661.44 |
| Max. Negotiated Rate |
$10,080.84 |
| Rate for Payer: Aetna Medicare |
$8,387.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,080.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,080.84
|
| Rate for Payer: BCBS MAPPO |
$8,064.67
|
| Rate for Payer: BCN Medicare Advantage |
$8,064.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,064.67
|
| Rate for Payer: Mclaren Medicare |
$8,064.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,467.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,274.37
|
| Rate for Payer: PACE Medicare |
$7,661.44
|
| Rate for Payer: PACE SWMI |
$8,064.67
|
| Rate for Payer: PHP Medicare Advantage |
$8,064.67
|
| Rate for Payer: Priority Health Medicare |
$8,064.67
|
| Rate for Payer: Railroad Medicare Medicare |
$8,064.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,064.67
|
| Rate for Payer: UHC Medicare Advantage |
$8,064.67
|
| Rate for Payer: VA VA |
$8,064.67
|
|
|
MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$6,693.00
|
|
|
Service Code
|
MSDRG 761
|
| Min. Negotiated Rate |
$5,086.68 |
| Max. Negotiated Rate |
$6,693.00 |
| Rate for Payer: Aetna Medicare |
$5,568.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,693.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,693.00
|
| Rate for Payer: BCBS MAPPO |
$5,354.40
|
| Rate for Payer: BCN Medicare Advantage |
$5,354.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,354.40
|
| Rate for Payer: Mclaren Medicare |
$5,354.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,622.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,157.56
|
| Rate for Payer: PACE Medicare |
$5,086.68
|
| Rate for Payer: PACE SWMI |
$5,354.40
|
| Rate for Payer: PHP Medicare Advantage |
$5,354.40
|
| Rate for Payer: Priority Health Medicare |
$5,354.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5,354.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,354.40
|
| Rate for Payer: UHC Medicare Advantage |
$5,354.40
|
| Rate for Payer: VA VA |
$5,354.40
|
|
