|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$11,457.97
|
|
|
Service Code
|
APR-DRG 4842
|
| Min. Negotiated Rate |
$10,912.36 |
| Max. Negotiated Rate |
$11,457.97 |
| Rate for Payer: BCBS Complete |
$11,457.97
|
| Rate for Payer: Mclaren Medicaid |
$10,912.36
|
| Rate for Payer: Meridian Medicaid |
$11,457.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,912.36
|
| Rate for Payer: UHC Medicaid |
$10,912.36
|
| Rate for Payer: UHCCP Medicaid |
$10,912.36
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$29,929.13
|
|
|
Service Code
|
APR-DRG 4844
|
| Min. Negotiated Rate |
$28,503.93 |
| Max. Negotiated Rate |
$29,929.13 |
| Rate for Payer: BCBS Complete |
$29,929.13
|
| Rate for Payer: Mclaren Medicaid |
$28,503.93
|
| Rate for Payer: Meridian Medicaid |
$29,929.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$28,503.93
|
| Rate for Payer: UHC Medicaid |
$28,503.93
|
| Rate for Payer: UHCCP Medicaid |
$28,503.93
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$16,062.15
|
|
|
Service Code
|
APR-DRG 4843
|
| Min. Negotiated Rate |
$15,297.28 |
| Max. Negotiated Rate |
$16,062.15 |
| Rate for Payer: BCBS Complete |
$16,062.15
|
| Rate for Payer: Mclaren Medicaid |
$15,297.28
|
| Rate for Payer: Meridian Medicaid |
$16,062.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,297.28
|
| Rate for Payer: UHC Medicaid |
$15,297.28
|
| Rate for Payer: UHCCP Medicaid |
$15,297.28
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
|
Facility
|
IP
|
$19,562.07
|
|
|
Service Code
|
MSDRG 729
|
| Min. Negotiated Rate |
$8,322.82 |
| Max. Negotiated Rate |
$19,562.07 |
| Rate for Payer: Aetna Medicare |
$9,111.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,951.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,951.08
|
| Rate for Payer: BCBS MAPPO |
$8,760.86
|
| Rate for Payer: BCBS Trust/PPO |
$19,562.07
|
| Rate for Payer: BCN Commercial |
$19,562.07
|
| Rate for Payer: BCN Medicare Advantage |
$8,760.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,760.86
|
| Rate for Payer: Mclaren Medicare |
$8,760.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,198.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,074.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,636.95
|
| Rate for Payer: Nomi Health Commercial |
$13,657.23
|
| Rate for Payer: PACE Medicare |
$8,322.82
|
| Rate for Payer: PACE SWMI |
$8,760.86
|
| Rate for Payer: PHP Medicare Advantage |
$8,760.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,068.51
|
| Rate for Payer: Priority Health Medicare |
$8,760.86
|
| Rate for Payer: Priority Health Tiered Network |
$13,654.81
|
| Rate for Payer: Railroad Medicare Medicare |
$8,760.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,256.81
|
| Rate for Payer: UHC Core |
$14,437.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,760.86
|
| Rate for Payer: UHC Exchange |
$11,790.74
|
| Rate for Payer: VA VA |
$8,760.86
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$13,220.84
|
|
|
Service Code
|
MSDRG 730
|
| Min. Negotiated Rate |
$5,483.74 |
| Max. Negotiated Rate |
$13,220.84 |
| Rate for Payer: Aetna Medicare |
$6,003.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,215.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,215.45
|
| Rate for Payer: BCBS MAPPO |
$5,772.36
|
| Rate for Payer: BCBS Trust/PPO |
$13,220.84
|
| Rate for Payer: BCN Commercial |
$13,220.84
|
| Rate for Payer: BCN Medicare Advantage |
$5,772.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,772.36
|
| Rate for Payer: Mclaren Medicare |
$5,772.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,060.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,638.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,349.60
|
| Rate for Payer: Nomi Health Commercial |
$8,668.80
|
| Rate for Payer: PACE Medicare |
$5,483.74
|
| Rate for Payer: PACE SWMI |
$5,772.36
|
| Rate for Payer: PHP Medicare Advantage |
$5,772.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,834.08
|
| Rate for Payer: Priority Health Medicare |
$5,772.36
|
| Rate for Payer: Priority Health Tiered Network |
$8,667.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,772.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,953.60
|
| Rate for Payer: UHC Core |
$9,164.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,772.36
|
| Rate for Payer: UHC Exchange |
$7,484.06
|
| Rate for Payer: VA VA |
$5,772.36
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$30,815.15
|
|
|
Service Code
|
MSDRG 717
|
| Min. Negotiated Rate |
$14,429.76 |
| Max. Negotiated Rate |
$30,815.15 |
| Rate for Payer: Aetna Medicare |
$15,796.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,986.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,986.53
|
| Rate for Payer: BCBS MAPPO |
$15,189.22
|
| Rate for Payer: BCBS Trust/PPO |
$27,417.79
|
| Rate for Payer: BCN Commercial |
$27,417.79
|
| Rate for Payer: BCN Medicare Advantage |
$15,189.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,189.22
|
| Rate for Payer: Mclaren Medicare |
$15,189.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,948.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,467.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,708.14
|
| Rate for Payer: Nomi Health Commercial |
$24,387.45
|
| Rate for Payer: PACE Medicare |
$14,429.76
|
| Rate for Payer: PACE SWMI |
$15,189.22
|
| Rate for Payer: PHP Medicare Advantage |
$15,189.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30,478.91
|
| Rate for Payer: Priority Health Medicare |
$15,189.22
|
| Rate for Payer: Priority Health Tiered Network |
$24,383.12
|
| Rate for Payer: Railroad Medicare Medicare |
$15,189.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,815.15
|
| Rate for Payer: UHC Core |
$25,780.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,189.22
|
| Rate for Payer: UHC Exchange |
$21,054.50
|
| Rate for Payer: VA VA |
$15,189.22
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$21,892.53
|
|
|
Service Code
|
MSDRG 718
|
| Min. Negotiated Rate |
$10,410.84 |
| Max. Negotiated Rate |
$21,892.53 |
| Rate for Payer: Aetna Medicare |
$11,397.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,698.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,698.48
|
| Rate for Payer: BCBS MAPPO |
$10,958.78
|
| Rate for Payer: BCBS Trust/PPO |
$18,714.70
|
| Rate for Payer: BCN Commercial |
$18,714.70
|
| Rate for Payer: BCN Medicare Advantage |
$10,958.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,958.78
|
| Rate for Payer: Mclaren Medicare |
$10,958.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,506.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,602.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,054.66
|
| Rate for Payer: Nomi Health Commercial |
$17,325.99
|
| Rate for Payer: PACE Medicare |
$10,410.84
|
| Rate for Payer: PACE SWMI |
$10,958.78
|
| Rate for Payer: PHP Medicare Advantage |
$10,958.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21,653.65
|
| Rate for Payer: Priority Health Medicare |
$10,958.78
|
| Rate for Payer: Priority Health Tiered Network |
$17,322.91
|
| Rate for Payer: Railroad Medicare Medicare |
$10,958.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,892.53
|
| Rate for Payer: UHC Core |
$18,315.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,958.78
|
| Rate for Payer: UHC Exchange |
$14,958.10
|
| Rate for Payer: VA VA |
$10,958.78
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$48,646.51
|
|
|
Service Code
|
MSDRG 715
|
| Min. Negotiated Rate |
$16,975.90 |
| Max. Negotiated Rate |
$48,646.51 |
| Rate for Payer: Aetna Medicare |
$18,584.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,336.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,336.71
|
| Rate for Payer: BCBS MAPPO |
$17,869.37
|
| Rate for Payer: BCBS Trust/PPO |
$48,646.51
|
| Rate for Payer: BCN Commercial |
$48,646.51
|
| Rate for Payer: BCN Medicare Advantage |
$17,869.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,869.37
|
| Rate for Payer: Mclaren Medicare |
$17,869.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,762.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,549.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,656.31
|
| Rate for Payer: Nomi Health Commercial |
$28,861.17
|
| Rate for Payer: PACE Medicare |
$16,975.90
|
| Rate for Payer: PACE SWMI |
$17,869.37
|
| Rate for Payer: PHP Medicare Advantage |
$17,869.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$36,070.06
|
| Rate for Payer: Priority Health Medicare |
$17,869.37
|
| Rate for Payer: Priority Health Tiered Network |
$28,856.05
|
| Rate for Payer: Railroad Medicare Medicare |
$17,869.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36,467.99
|
| Rate for Payer: UHC Core |
$30,510.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,869.37
|
| Rate for Payer: UHC Exchange |
$24,916.81
|
| Rate for Payer: VA VA |
$17,869.37
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$31,888.72
|
|
|
Service Code
|
MSDRG 716
|
| Min. Negotiated Rate |
$11,349.87 |
| Max. Negotiated Rate |
$31,888.72 |
| Rate for Payer: Aetna Medicare |
$12,425.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,934.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,934.04
|
| Rate for Payer: BCBS MAPPO |
$11,947.23
|
| Rate for Payer: BCBS Trust/PPO |
$31,888.72
|
| Rate for Payer: BCN Commercial |
$31,888.72
|
| Rate for Payer: BCN Medicare Advantage |
$11,947.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,947.23
|
| Rate for Payer: Mclaren Medicare |
$11,947.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,544.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,739.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,141.95
|
| Rate for Payer: Nomi Health Commercial |
$18,975.90
|
| Rate for Payer: PACE Medicare |
$11,349.87
|
| Rate for Payer: PACE SWMI |
$11,947.23
|
| Rate for Payer: PHP Medicare Advantage |
$11,947.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,715.67
|
| Rate for Payer: Priority Health Medicare |
$11,947.23
|
| Rate for Payer: Priority Health Tiered Network |
$18,972.53
|
| Rate for Payer: Railroad Medicare Medicare |
$11,947.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,977.30
|
| Rate for Payer: UHC Core |
$20,060.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,947.23
|
| Rate for Payer: UHC Exchange |
$16,382.53
|
| Rate for Payer: VA VA |
$11,947.23
|
|
|
OTHER MENTAL DISORDER DIAGNOSES
|
Facility
|
IP
|
$17,455.67
|
|
|
Service Code
|
MSDRG 887
|
| Min. Negotiated Rate |
$1,069.00 |
| Max. Negotiated Rate |
$17,455.67 |
| Rate for Payer: Aetna Medicare |
$9,209.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,068.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,068.95
|
| Rate for Payer: BCBS MAPPO |
$8,855.16
|
| Rate for Payer: BCBS Trust/PPO |
$16,380.92
|
| Rate for Payer: BCN Commercial |
$16,380.92
|
| Rate for Payer: BCN Medicare Advantage |
$8,855.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,855.16
|
| Rate for Payer: Mclaren Medicare |
$8,855.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,297.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,183.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,740.68
|
| Rate for Payer: Nomi Health Commercial |
$1,069.00
|
| Rate for Payer: PACE Medicare |
$8,412.40
|
| Rate for Payer: PACE SWMI |
$8,855.16
|
| Rate for Payer: PHP Medicare Advantage |
$8,855.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,265.20
|
| Rate for Payer: Priority Health Medicare |
$8,855.16
|
| Rate for Payer: Priority Health Tiered Network |
$13,812.16
|
| Rate for Payer: Railroad Medicare Medicare |
$8,855.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,455.67
|
| Rate for Payer: UHC Core |
$14,603.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,855.16
|
| Rate for Payer: UHC Exchange |
$11,926.61
|
| Rate for Payer: VA VA |
$8,855.16
|
|
|
OTHER MENTAL HEALTH CONDITIONS AND DISORDERS
|
Facility
|
IP
|
$10,424.89
|
|
|
Service Code
|
APR-DRG 7604
|
| Min. Negotiated Rate |
$9,928.46 |
| Max. Negotiated Rate |
$10,424.89 |
| Rate for Payer: BCBS Complete |
$10,424.89
|
| Rate for Payer: Mclaren Medicaid |
$9,928.46
|
| Rate for Payer: Meridian Medicaid |
$10,424.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,928.46
|
| Rate for Payer: UHC Medicaid |
$9,928.46
|
| Rate for Payer: UHCCP Medicaid |
$9,928.46
|
|
|
OTHER MENTAL HEALTH CONDITIONS AND DISORDERS
|
Facility
|
IP
|
$2,241.60
|
|
|
Service Code
|
APR-DRG 7601
|
| Min. Negotiated Rate |
$2,134.86 |
| Max. Negotiated Rate |
$2,241.60 |
| Rate for Payer: BCBS Complete |
$2,241.60
|
| Rate for Payer: Mclaren Medicaid |
$2,134.86
|
| Rate for Payer: Meridian Medicaid |
$2,241.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,134.86
|
| Rate for Payer: UHC Medicaid |
$2,134.86
|
| Rate for Payer: UHCCP Medicaid |
$2,134.86
|
|
|
OTHER MENTAL HEALTH CONDITIONS AND DISORDERS
|
Facility
|
IP
|
$3,439.23
|
|
|
Service Code
|
APR-DRG 7602
|
| Min. Negotiated Rate |
$3,275.45 |
| Max. Negotiated Rate |
$3,439.23 |
| Rate for Payer: BCBS Complete |
$3,439.23
|
| Rate for Payer: Mclaren Medicaid |
$3,275.45
|
| Rate for Payer: Meridian Medicaid |
$3,439.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,275.45
|
| Rate for Payer: UHC Medicaid |
$3,275.45
|
| Rate for Payer: UHCCP Medicaid |
$3,275.45
|
|
|
OTHER MENTAL HEALTH CONDITIONS AND DISORDERS
|
Facility
|
IP
|
$4,565.76
|
|
|
Service Code
|
APR-DRG 7603
|
| Min. Negotiated Rate |
$4,348.34 |
| Max. Negotiated Rate |
$4,565.76 |
| Rate for Payer: BCBS Complete |
$4,565.76
|
| Rate for Payer: Mclaren Medicaid |
$4,348.34
|
| Rate for Payer: Meridian Medicaid |
$4,565.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,348.34
|
| Rate for Payer: UHC Medicaid |
$4,348.34
|
| Rate for Payer: UHCCP Medicaid |
$4,348.34
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC
|
Facility
|
IP
|
$24,981.38
|
|
|
Service Code
|
MSDRG 964
|
| Min. Negotiated Rate |
$11,802.11 |
| Max. Negotiated Rate |
$24,981.38 |
| Rate for Payer: Aetna Medicare |
$12,920.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,529.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,529.09
|
| Rate for Payer: BCBS MAPPO |
$12,423.27
|
| Rate for Payer: BCBS Trust/PPO |
$24,491.79
|
| Rate for Payer: BCN Commercial |
$24,491.79
|
| Rate for Payer: BCN Medicare Advantage |
$12,423.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,423.27
|
| Rate for Payer: Mclaren Medicare |
$12,423.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,044.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,286.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,665.60
|
| Rate for Payer: Nomi Health Commercial |
$19,770.54
|
| Rate for Payer: PACE Medicare |
$11,802.11
|
| Rate for Payer: PACE SWMI |
$12,423.27
|
| Rate for Payer: PHP Medicare Advantage |
$12,423.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,708.79
|
| Rate for Payer: Priority Health Medicare |
$12,423.27
|
| Rate for Payer: Priority Health Tiered Network |
$19,767.03
|
| Rate for Payer: Railroad Medicare Medicare |
$12,423.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,981.38
|
| Rate for Payer: UHC Core |
$20,900.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,423.27
|
| Rate for Payer: UHC Exchange |
$17,068.57
|
| Rate for Payer: VA VA |
$12,423.27
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$55,832.76
|
|
|
Service Code
|
MSDRG 963
|
| Min. Negotiated Rate |
$20,621.11 |
| Max. Negotiated Rate |
$55,832.76 |
| Rate for Payer: Aetna Medicare |
$22,574.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,133.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,133.04
|
| Rate for Payer: BCBS MAPPO |
$21,706.43
|
| Rate for Payer: BCBS Trust/PPO |
$55,832.76
|
| Rate for Payer: BCN Commercial |
$55,832.76
|
| Rate for Payer: BCN Medicare Advantage |
$21,706.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,706.43
|
| Rate for Payer: Mclaren Medicare |
$21,706.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,791.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,962.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$23,877.07
|
| Rate for Payer: Nomi Health Commercial |
$35,266.02
|
| Rate for Payer: PACE Medicare |
$20,621.11
|
| Rate for Payer: PACE SWMI |
$21,706.43
|
| Rate for Payer: PHP Medicare Advantage |
$21,706.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$44,074.71
|
| Rate for Payer: Priority Health Medicare |
$21,706.43
|
| Rate for Payer: Priority Health Tiered Network |
$35,259.76
|
| Rate for Payer: Railroad Medicare Medicare |
$21,706.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,560.94
|
| Rate for Payer: UHC Core |
$37,280.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21,706.43
|
| Rate for Payer: UHC Exchange |
$30,446.33
|
| Rate for Payer: VA VA |
$21,706.43
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$15,330.15
|
|
|
Service Code
|
MSDRG 965
|
| Min. Negotiated Rate |
$7,455.03 |
| Max. Negotiated Rate |
$15,330.15 |
| Rate for Payer: Aetna Medicare |
$8,161.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,809.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,809.25
|
| Rate for Payer: BCBS MAPPO |
$7,847.40
|
| Rate for Payer: BCBS Trust/PPO |
$14,733.00
|
| Rate for Payer: BCN Commercial |
$14,733.00
|
| Rate for Payer: BCN Medicare Advantage |
$7,847.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,847.40
|
| Rate for Payer: Mclaren Medicare |
$7,847.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,239.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,024.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,632.14
|
| Rate for Payer: Nomi Health Commercial |
$12,132.45
|
| Rate for Payer: PACE Medicare |
$7,455.03
|
| Rate for Payer: PACE SWMI |
$7,847.40
|
| Rate for Payer: PHP Medicare Advantage |
$7,847.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15,162.87
|
| Rate for Payer: Priority Health Medicare |
$7,847.40
|
| Rate for Payer: Priority Health Tiered Network |
$12,130.30
|
| Rate for Payer: Railroad Medicare Medicare |
$7,847.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,330.15
|
| Rate for Payer: UHC Core |
$12,825.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,847.40
|
| Rate for Payer: UHC Exchange |
$10,474.35
|
| Rate for Payer: VA VA |
$7,847.40
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$6,002.45
|
|
|
Service Code
|
APR-DRG 3513
|
| Min. Negotiated Rate |
$5,716.62 |
| Max. Negotiated Rate |
$6,002.45 |
| Rate for Payer: BCBS Complete |
$6,002.45
|
| Rate for Payer: Mclaren Medicaid |
$5,716.62
|
| Rate for Payer: Meridian Medicaid |
$6,002.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,716.62
|
| Rate for Payer: UHC Medicaid |
$5,716.62
|
| Rate for Payer: UHCCP Medicaid |
$5,716.62
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$8,404.00
|
|
|
Service Code
|
APR-DRG 3514
|
| Min. Negotiated Rate |
$8,003.81 |
| Max. Negotiated Rate |
$8,404.00 |
| Rate for Payer: BCBS Complete |
$8,404.00
|
| Rate for Payer: Mclaren Medicaid |
$8,003.81
|
| Rate for Payer: Meridian Medicaid |
$8,404.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,003.81
|
| Rate for Payer: UHC Medicaid |
$8,003.81
|
| Rate for Payer: UHCCP Medicaid |
$8,003.81
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$2,868.79
|
|
|
Service Code
|
APR-DRG 3511
|
| Min. Negotiated Rate |
$2,732.18 |
| Max. Negotiated Rate |
$2,868.79 |
| Rate for Payer: BCBS Complete |
$2,868.79
|
| Rate for Payer: Mclaren Medicaid |
$2,732.18
|
| Rate for Payer: Meridian Medicaid |
$2,868.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,732.18
|
| Rate for Payer: UHC Medicaid |
$2,732.18
|
| Rate for Payer: UHCCP Medicaid |
$2,732.18
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$3,836.52
|
|
|
Service Code
|
APR-DRG 3512
|
| Min. Negotiated Rate |
$3,653.83 |
| Max. Negotiated Rate |
$3,836.52 |
| Rate for Payer: BCBS Complete |
$3,836.52
|
| Rate for Payer: Mclaren Medicaid |
$3,653.83
|
| Rate for Payer: Meridian Medicaid |
$3,836.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,653.83
|
| Rate for Payer: UHC Medicaid |
$3,653.83
|
| Rate for Payer: UHCCP Medicaid |
$3,653.83
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC
|
Facility
|
IP
|
$15,882.72
|
|
|
Service Code
|
MSDRG 565
|
| Min. Negotiated Rate |
$7,703.92 |
| Max. Negotiated Rate |
$15,882.72 |
| Rate for Payer: Aetna Medicare |
$8,433.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,136.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,136.74
|
| Rate for Payer: BCBS MAPPO |
$8,109.39
|
| Rate for Payer: BCBS Trust/PPO |
$15,386.08
|
| Rate for Payer: BCN Commercial |
$15,386.08
|
| Rate for Payer: BCN Medicare Advantage |
$8,109.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,109.39
|
| Rate for Payer: Mclaren Medicare |
$8,109.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,514.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,325.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,920.33
|
| Rate for Payer: Nomi Health Commercial |
$12,569.76
|
| Rate for Payer: PACE Medicare |
$7,703.92
|
| Rate for Payer: PACE SWMI |
$8,109.39
|
| Rate for Payer: PHP Medicare Advantage |
$8,109.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15,709.41
|
| Rate for Payer: Priority Health Medicare |
$8,109.39
|
| Rate for Payer: Priority Health Tiered Network |
$12,567.53
|
| Rate for Payer: Railroad Medicare Medicare |
$8,109.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,882.72
|
| Rate for Payer: UHC Core |
$13,287.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,109.39
|
| Rate for Payer: UHC Exchange |
$10,851.89
|
| Rate for Payer: VA VA |
$8,109.39
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC
|
Facility
|
IP
|
$34,318.47
|
|
|
Service Code
|
MSDRG 564
|
| Min. Negotiated Rate |
$11,882.88 |
| Max. Negotiated Rate |
$34,318.47 |
| Rate for Payer: Aetna Medicare |
$13,008.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,635.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,635.36
|
| Rate for Payer: BCBS MAPPO |
$12,508.29
|
| Rate for Payer: BCBS Trust/PPO |
$34,318.47
|
| Rate for Payer: BCN Commercial |
$34,318.47
|
| Rate for Payer: BCN Medicare Advantage |
$12,508.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,508.29
|
| Rate for Payer: Mclaren Medicare |
$12,508.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,133.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,384.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,759.12
|
| Rate for Payer: Nomi Health Commercial |
$19,912.44
|
| Rate for Payer: PACE Medicare |
$11,882.88
|
| Rate for Payer: PACE SWMI |
$12,508.29
|
| Rate for Payer: PHP Medicare Advantage |
$12,508.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,886.14
|
| Rate for Payer: Priority Health Medicare |
$12,508.29
|
| Rate for Payer: Priority Health Tiered Network |
$19,908.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12,508.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,160.68
|
| Rate for Payer: UHC Core |
$21,050.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,508.29
|
| Rate for Payer: UHC Exchange |
$17,191.07
|
| Rate for Payer: VA VA |
$12,508.29
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$12,213.59
|
|
|
Service Code
|
MSDRG 566
|
| Min. Negotiated Rate |
$6,051.27 |
| Max. Negotiated Rate |
$12,213.59 |
| Rate for Payer: Aetna Medicare |
$6,624.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,962.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,962.20
|
| Rate for Payer: BCBS MAPPO |
$6,369.76
|
| Rate for Payer: BCBS Trust/PPO |
$10,723.20
|
| Rate for Payer: BCN Commercial |
$10,723.20
|
| Rate for Payer: BCN Medicare Advantage |
$6,369.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,369.76
|
| Rate for Payer: Mclaren Medicare |
$6,369.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,688.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,325.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,006.74
|
| Rate for Payer: Nomi Health Commercial |
$9,665.97
|
| Rate for Payer: PACE Medicare |
$6,051.27
|
| Rate for Payer: PACE SWMI |
$6,369.76
|
| Rate for Payer: PHP Medicare Advantage |
$6,369.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,080.32
|
| Rate for Payer: Priority Health Medicare |
$6,369.76
|
| Rate for Payer: Priority Health Tiered Network |
$9,664.25
|
| Rate for Payer: Railroad Medicare Medicare |
$6,369.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,213.59
|
| Rate for Payer: UHC Core |
$10,218.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,369.76
|
| Rate for Payer: UHC Exchange |
$8,344.95
|
| Rate for Payer: VA VA |
$6,369.76
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$41,820.73
|
|
|
Service Code
|
MSDRG 516
|
| Min. Negotiated Rate |
$15,807.08 |
| Max. Negotiated Rate |
$41,820.73 |
| Rate for Payer: Aetna Medicare |
$17,304.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,798.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,798.79
|
| Rate for Payer: BCBS MAPPO |
$16,639.03
|
| Rate for Payer: BCBS Trust/PPO |
$41,820.73
|
| Rate for Payer: BCN Commercial |
$41,820.73
|
| Rate for Payer: BCN Medicare Advantage |
$16,639.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,639.03
|
| Rate for Payer: Mclaren Medicare |
$16,639.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,470.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,134.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,302.93
|
| Rate for Payer: Nomi Health Commercial |
$26,807.49
|
| Rate for Payer: PACE Medicare |
$15,807.08
|
| Rate for Payer: PACE SWMI |
$16,639.03
|
| Rate for Payer: PHP Medicare Advantage |
$16,639.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33,503.42
|
| Rate for Payer: Priority Health Medicare |
$16,639.03
|
| Rate for Payer: Priority Health Tiered Network |
$26,802.73
|
| Rate for Payer: Railroad Medicare Medicare |
$16,639.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33,873.03
|
| Rate for Payer: UHC Core |
$28,339.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,639.03
|
| Rate for Payer: UHC Exchange |
$23,143.80
|
| Rate for Payer: VA VA |
$16,639.03
|
|
