|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$31,086.05
|
|
|
Service Code
|
APR-DRG 6234
|
| Min. Negotiated Rate |
$29,605.76 |
| Max. Negotiated Rate |
$31,086.05 |
| Rate for Payer: BCBS Complete |
$31,086.05
|
| Rate for Payer: Mclaren Medicaid |
$29,605.76
|
| Rate for Payer: Meridian Medicaid |
$31,086.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$29,605.76
|
| Rate for Payer: UHC Medicaid |
$29,605.76
|
| Rate for Payer: UHCCP Medicaid |
$29,605.76
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$6,831.44
|
|
|
Service Code
|
APR-DRG 6232
|
| Min. Negotiated Rate |
$6,506.14 |
| Max. Negotiated Rate |
$6,831.44 |
| Rate for Payer: BCBS Complete |
$6,831.44
|
| Rate for Payer: Mclaren Medicaid |
$6,506.14
|
| Rate for Payer: Meridian Medicaid |
$6,831.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,506.14
|
| Rate for Payer: UHC Medicaid |
$6,506.14
|
| Rate for Payer: UHCCP Medicaid |
$6,506.14
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$3,939.72
|
|
|
Service Code
|
APR-DRG 6231
|
| Min. Negotiated Rate |
$3,752.11 |
| Max. Negotiated Rate |
$3,939.72 |
| Rate for Payer: BCBS Complete |
$3,939.72
|
| Rate for Payer: Mclaren Medicaid |
$3,752.11
|
| Rate for Payer: Meridian Medicaid |
$3,939.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,752.11
|
| Rate for Payer: UHC Medicaid |
$3,752.11
|
| Rate for Payer: UHCCP Medicaid |
$3,752.11
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$17,600.88
|
|
|
Service Code
|
APR-DRG 6233
|
| Min. Negotiated Rate |
$16,762.75 |
| Max. Negotiated Rate |
$17,600.88 |
| Rate for Payer: BCBS Complete |
$17,600.88
|
| Rate for Payer: Mclaren Medicaid |
$16,762.75
|
| Rate for Payer: Meridian Medicaid |
$17,600.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,762.75
|
| Rate for Payer: UHC Medicaid |
$16,762.75
|
| Rate for Payer: UHCCP Medicaid |
$16,762.75
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$9,204.90
|
|
|
Service Code
|
APR-DRG 6213
|
| Min. Negotiated Rate |
$8,766.58 |
| Max. Negotiated Rate |
$9,204.90 |
| Rate for Payer: BCBS Complete |
$9,204.90
|
| Rate for Payer: Mclaren Medicaid |
$8,766.58
|
| Rate for Payer: Meridian Medicaid |
$9,204.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,766.58
|
| Rate for Payer: UHC Medicaid |
$8,766.58
|
| Rate for Payer: UHCCP Medicaid |
$8,766.58
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$18,756.08
|
|
|
Service Code
|
APR-DRG 6214
|
| Min. Negotiated Rate |
$17,862.94 |
| Max. Negotiated Rate |
$18,756.08 |
| Rate for Payer: BCBS Complete |
$18,756.08
|
| Rate for Payer: Mclaren Medicaid |
$17,862.94
|
| Rate for Payer: Meridian Medicaid |
$18,756.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,862.94
|
| Rate for Payer: UHC Medicaid |
$17,862.94
|
| Rate for Payer: UHCCP Medicaid |
$17,862.94
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$1,307.70
|
|
|
Service Code
|
APR-DRG 6211
|
| Min. Negotiated Rate |
$1,245.43 |
| Max. Negotiated Rate |
$1,307.70 |
| Rate for Payer: BCBS Complete |
$1,307.70
|
| Rate for Payer: Mclaren Medicaid |
$1,245.43
|
| Rate for Payer: Meridian Medicaid |
$1,307.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,245.43
|
| Rate for Payer: UHC Medicaid |
$1,245.43
|
| Rate for Payer: UHCCP Medicaid |
$1,245.43
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$7,755.60
|
|
|
Service Code
|
APR-DRG 6212
|
| Min. Negotiated Rate |
$7,386.29 |
| Max. Negotiated Rate |
$7,755.60 |
| Rate for Payer: BCBS Complete |
$7,755.60
|
| Rate for Payer: Mclaren Medicaid |
$7,386.29
|
| Rate for Payer: Meridian Medicaid |
$7,755.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,386.29
|
| Rate for Payer: UHC Medicaid |
$7,386.29
|
| Rate for Payer: UHCCP Medicaid |
$7,386.29
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$9,176.81
|
|
|
Service Code
|
APR-DRG 6252
|
| Min. Negotiated Rate |
$8,739.82 |
| Max. Negotiated Rate |
$9,176.81 |
| Rate for Payer: BCBS Complete |
$9,176.81
|
| Rate for Payer: Mclaren Medicaid |
$8,739.82
|
| Rate for Payer: Meridian Medicaid |
$9,176.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,739.82
|
| Rate for Payer: UHC Medicaid |
$8,739.82
|
| Rate for Payer: UHCCP Medicaid |
$8,739.82
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$40,045.58
|
|
|
Service Code
|
APR-DRG 6254
|
| Min. Negotiated Rate |
$38,138.65 |
| Max. Negotiated Rate |
$40,045.58 |
| Rate for Payer: BCBS Complete |
$40,045.58
|
| Rate for Payer: Mclaren Medicaid |
$38,138.65
|
| Rate for Payer: Meridian Medicaid |
$40,045.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$38,138.65
|
| Rate for Payer: UHC Medicaid |
$38,138.65
|
| Rate for Payer: UHCCP Medicaid |
$38,138.65
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$4,706.22
|
|
|
Service Code
|
APR-DRG 6251
|
| Min. Negotiated Rate |
$4,482.11 |
| Max. Negotiated Rate |
$4,706.22 |
| Rate for Payer: BCBS Complete |
$4,706.22
|
| Rate for Payer: Mclaren Medicaid |
$4,482.11
|
| Rate for Payer: Meridian Medicaid |
$4,706.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,482.11
|
| Rate for Payer: UHC Medicaid |
$4,482.11
|
| Rate for Payer: UHCCP Medicaid |
$4,482.11
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$18,777.87
|
|
|
Service Code
|
APR-DRG 6253
|
| Min. Negotiated Rate |
$17,883.68 |
| Max. Negotiated Rate |
$18,777.87 |
| Rate for Payer: BCBS Complete |
$18,777.87
|
| Rate for Payer: Mclaren Medicaid |
$17,883.68
|
| Rate for Payer: Meridian Medicaid |
$18,777.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,883.68
|
| Rate for Payer: UHC Medicaid |
$17,883.68
|
| Rate for Payer: UHCCP Medicaid |
$17,883.68
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$22,612.67
|
|
|
Service Code
|
APR-DRG 6223
|
| Min. Negotiated Rate |
$21,535.88 |
| Max. Negotiated Rate |
$22,612.67 |
| Rate for Payer: BCBS Complete |
$22,612.67
|
| Rate for Payer: Mclaren Medicaid |
$21,535.88
|
| Rate for Payer: Meridian Medicaid |
$22,612.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,535.88
|
| Rate for Payer: UHC Medicaid |
$21,535.88
|
| Rate for Payer: UHCCP Medicaid |
$21,535.88
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$8,538.16
|
|
|
Service Code
|
APR-DRG 6222
|
| Min. Negotiated Rate |
$8,131.58 |
| Max. Negotiated Rate |
$8,538.16 |
| Rate for Payer: BCBS Complete |
$8,538.16
|
| Rate for Payer: Mclaren Medicaid |
$8,131.58
|
| Rate for Payer: Meridian Medicaid |
$8,538.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,131.58
|
| Rate for Payer: UHC Medicaid |
$8,131.58
|
| Rate for Payer: UHCCP Medicaid |
$8,131.58
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$30,110.86
|
|
|
Service Code
|
APR-DRG 6224
|
| Min. Negotiated Rate |
$28,677.01 |
| Max. Negotiated Rate |
$30,110.86 |
| Rate for Payer: BCBS Complete |
$30,110.86
|
| Rate for Payer: Mclaren Medicaid |
$28,677.01
|
| Rate for Payer: Meridian Medicaid |
$30,110.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$28,677.01
|
| Rate for Payer: UHC Medicaid |
$28,677.01
|
| Rate for Payer: UHCCP Medicaid |
$28,677.01
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$6,398.60
|
|
|
Service Code
|
APR-DRG 6221
|
| Min. Negotiated Rate |
$6,093.91 |
| Max. Negotiated Rate |
$6,398.60 |
| Rate for Payer: BCBS Complete |
$6,398.60
|
| Rate for Payer: Mclaren Medicaid |
$6,093.91
|
| Rate for Payer: Meridian Medicaid |
$6,398.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,093.91
|
| Rate for Payer: UHC Medicaid |
$6,093.91
|
| Rate for Payer: UHCCP Medicaid |
$6,093.91
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$828.42
|
|
|
Service Code
|
APR-DRG 6401
|
| Min. Negotiated Rate |
$788.97 |
| Max. Negotiated Rate |
$828.42 |
| Rate for Payer: BCBS Complete |
$828.42
|
| Rate for Payer: Mclaren Medicaid |
$788.97
|
| Rate for Payer: Meridian Medicaid |
$828.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.97
|
| Rate for Payer: UHC Medicaid |
$788.97
|
| Rate for Payer: UHCCP Medicaid |
$788.97
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,138.00
|
|
|
Service Code
|
APR-DRG 6402
|
| Min. Negotiated Rate |
$1,083.81 |
| Max. Negotiated Rate |
$1,138.00 |
| Rate for Payer: BCBS Complete |
$1,138.00
|
| Rate for Payer: Mclaren Medicaid |
$1,083.81
|
| Rate for Payer: Meridian Medicaid |
$1,138.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,083.81
|
| Rate for Payer: UHC Medicaid |
$1,083.81
|
| Rate for Payer: UHCCP Medicaid |
$1,083.81
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$4,308.35
|
|
|
Service Code
|
APR-DRG 6404
|
| Min. Negotiated Rate |
$4,103.19 |
| Max. Negotiated Rate |
$4,308.35 |
| Rate for Payer: BCBS Complete |
$4,308.35
|
| Rate for Payer: Mclaren Medicaid |
$4,103.19
|
| Rate for Payer: Meridian Medicaid |
$4,308.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,103.19
|
| Rate for Payer: UHC Medicaid |
$4,103.19
|
| Rate for Payer: UHCCP Medicaid |
$4,103.19
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,763.47
|
|
|
Service Code
|
APR-DRG 6403
|
| Min. Negotiated Rate |
$1,679.50 |
| Max. Negotiated Rate |
$1,763.47 |
| Rate for Payer: BCBS Complete |
$1,763.47
|
| Rate for Payer: Mclaren Medicaid |
$1,679.50
|
| Rate for Payer: Meridian Medicaid |
$1,763.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,679.50
|
| Rate for Payer: UHC Medicaid |
$1,679.50
|
| Rate for Payer: UHCCP Medicaid |
$1,679.50
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$5,841.35
|
|
|
Service Code
|
APR-DRG 6362
|
| Min. Negotiated Rate |
$5,563.19 |
| Max. Negotiated Rate |
$5,841.35 |
| Rate for Payer: BCBS Complete |
$5,841.35
|
| Rate for Payer: Mclaren Medicaid |
$5,563.19
|
| Rate for Payer: Meridian Medicaid |
$5,841.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,563.19
|
| Rate for Payer: UHC Medicaid |
$5,563.19
|
| Rate for Payer: UHCCP Medicaid |
$5,563.19
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$10,137.66
|
|
|
Service Code
|
APR-DRG 6363
|
| Min. Negotiated Rate |
$9,654.92 |
| Max. Negotiated Rate |
$10,137.66 |
| Rate for Payer: BCBS Complete |
$10,137.66
|
| Rate for Payer: Mclaren Medicaid |
$9,654.92
|
| Rate for Payer: Meridian Medicaid |
$10,137.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,654.92
|
| Rate for Payer: UHC Medicaid |
$9,654.92
|
| Rate for Payer: UHCCP Medicaid |
$9,654.92
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$18,626.52
|
|
|
Service Code
|
APR-DRG 6364
|
| Min. Negotiated Rate |
$17,739.54 |
| Max. Negotiated Rate |
$18,626.52 |
| Rate for Payer: BCBS Complete |
$18,626.52
|
| Rate for Payer: Mclaren Medicaid |
$17,739.54
|
| Rate for Payer: Meridian Medicaid |
$18,626.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,739.54
|
| Rate for Payer: UHC Medicaid |
$17,739.54
|
| Rate for Payer: UHCCP Medicaid |
$17,739.54
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$3,267.81
|
|
|
Service Code
|
APR-DRG 6361
|
| Min. Negotiated Rate |
$3,112.20 |
| Max. Negotiated Rate |
$3,267.81 |
| Rate for Payer: BCBS Complete |
$3,267.81
|
| Rate for Payer: Mclaren Medicaid |
$3,112.20
|
| Rate for Payer: Meridian Medicaid |
$3,267.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,112.20
|
| Rate for Payer: UHC Medicaid |
$3,112.20
|
| Rate for Payer: UHCCP Medicaid |
$3,112.20
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$3,716.70
|
|
|
Service Code
|
APR-DRG 6332
|
| Min. Negotiated Rate |
$3,539.72 |
| Max. Negotiated Rate |
$3,716.70 |
| Rate for Payer: BCBS Complete |
$3,716.70
|
| Rate for Payer: Mclaren Medicaid |
$3,539.72
|
| Rate for Payer: Meridian Medicaid |
$3,716.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,539.72
|
| Rate for Payer: UHC Medicaid |
$3,539.72
|
| Rate for Payer: UHCCP Medicaid |
$3,539.72
|
|