|
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI
|
Facility
|
IP
|
$15,477.95
|
|
|
Service Code
|
APR-DRG 1743
|
| Min. Negotiated Rate |
$14,740.91 |
| Max. Negotiated Rate |
$15,477.95 |
| Rate for Payer: BCBS Complete |
$15,477.95
|
| Rate for Payer: Mclaren Medicaid |
$14,740.91
|
| Rate for Payer: Meridian Medicaid |
$15,477.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,740.91
|
| Rate for Payer: UHC Medicaid |
$14,740.91
|
| Rate for Payer: UHCCP Medicaid |
$14,740.91
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI
|
Facility
|
IP
|
$13,763.79
|
|
|
Service Code
|
APR-DRG 1742
|
| Min. Negotiated Rate |
$13,108.37 |
| Max. Negotiated Rate |
$13,763.79 |
| Rate for Payer: BCBS Complete |
$13,763.79
|
| Rate for Payer: Mclaren Medicaid |
$13,108.37
|
| Rate for Payer: Meridian Medicaid |
$13,763.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,108.37
|
| Rate for Payer: UHC Medicaid |
$13,108.37
|
| Rate for Payer: UHCCP Medicaid |
$13,108.37
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI
|
Facility
|
IP
|
$22,371.31
|
|
|
Service Code
|
APR-DRG 1744
|
| Min. Negotiated Rate |
$21,306.01 |
| Max. Negotiated Rate |
$22,371.31 |
| Rate for Payer: BCBS Complete |
$22,371.31
|
| Rate for Payer: Mclaren Medicaid |
$21,306.01
|
| Rate for Payer: Meridian Medicaid |
$22,371.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,306.01
|
| Rate for Payer: UHC Medicaid |
$21,306.01
|
| Rate for Payer: UHCCP Medicaid |
$21,306.01
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI
|
Facility
|
IP
|
$10,984.43
|
|
|
Service Code
|
APR-DRG 1741
|
| Min. Negotiated Rate |
$10,461.36 |
| Max. Negotiated Rate |
$10,984.43 |
| Rate for Payer: BCBS Complete |
$10,984.43
|
| Rate for Payer: Mclaren Medicaid |
$10,461.36
|
| Rate for Payer: Meridian Medicaid |
$10,984.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,461.36
|
| Rate for Payer: UHC Medicaid |
$10,461.36
|
| Rate for Payer: UHCCP Medicaid |
$10,461.36
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI
|
Facility
|
IP
|
$12,019.81
|
|
|
Service Code
|
APR-DRG 1752
|
| Min. Negotiated Rate |
$11,447.44 |
| Max. Negotiated Rate |
$12,019.81 |
| Rate for Payer: BCBS Complete |
$12,019.81
|
| Rate for Payer: Mclaren Medicaid |
$11,447.44
|
| Rate for Payer: Meridian Medicaid |
$12,019.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,447.44
|
| Rate for Payer: UHC Medicaid |
$11,447.44
|
| Rate for Payer: UHCCP Medicaid |
$11,447.44
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI
|
Facility
|
IP
|
$9,042.09
|
|
|
Service Code
|
APR-DRG 1751
|
| Min. Negotiated Rate |
$8,611.51 |
| Max. Negotiated Rate |
$9,042.09 |
| Rate for Payer: BCBS Complete |
$9,042.09
|
| Rate for Payer: Mclaren Medicaid |
$8,611.51
|
| Rate for Payer: Meridian Medicaid |
$9,042.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,611.51
|
| Rate for Payer: UHC Medicaid |
$8,611.51
|
| Rate for Payer: UHCCP Medicaid |
$8,611.51
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI
|
Facility
|
IP
|
$15,500.89
|
|
|
Service Code
|
APR-DRG 1753
|
| Min. Negotiated Rate |
$14,762.75 |
| Max. Negotiated Rate |
$15,500.89 |
| Rate for Payer: BCBS Complete |
$15,500.89
|
| Rate for Payer: Mclaren Medicaid |
$14,762.75
|
| Rate for Payer: Meridian Medicaid |
$15,500.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,762.75
|
| Rate for Payer: UHC Medicaid |
$14,762.75
|
| Rate for Payer: UHCCP Medicaid |
$14,762.75
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI
|
Facility
|
IP
|
$25,108.82
|
|
|
Service Code
|
APR-DRG 1754
|
| Min. Negotiated Rate |
$23,913.16 |
| Max. Negotiated Rate |
$25,108.82 |
| Rate for Payer: BCBS Complete |
$25,108.82
|
| Rate for Payer: Mclaren Medicaid |
$23,913.16
|
| Rate for Payer: Meridian Medicaid |
$25,108.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,913.16
|
| Rate for Payer: UHC Medicaid |
$23,913.16
|
| Rate for Payer: UHCCP Medicaid |
$23,913.16
|
|
|
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES
|
Facility
|
IP
|
$56,909.53
|
|
|
Service Code
|
MSDRG 321
|
| Min. Negotiated Rate |
$20,525.66 |
| Max. Negotiated Rate |
$56,909.53 |
| Rate for Payer: Aetna Medicare |
$22,470.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,007.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,007.45
|
| Rate for Payer: BCBS MAPPO |
$21,605.96
|
| Rate for Payer: BCBS Trust/PPO |
$56,909.53
|
| Rate for Payer: BCN Commercial |
$56,909.53
|
| Rate for Payer: BCN Medicare Advantage |
$21,605.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,605.96
|
| Rate for Payer: Mclaren Medicare |
$21,605.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,686.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,846.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$23,766.56
|
| Rate for Payer: Nomi Health Commercial |
$35,098.32
|
| Rate for Payer: PACE Medicare |
$20,525.66
|
| Rate for Payer: PACE SWMI |
$21,605.96
|
| Rate for Payer: PHP Medicare Advantage |
$21,605.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$43,865.12
|
| Rate for Payer: Priority Health Medicare |
$21,605.96
|
| Rate for Payer: Priority Health Tiered Network |
$35,092.09
|
| Rate for Payer: Railroad Medicare Medicare |
$21,605.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,349.04
|
| Rate for Payer: UHC Core |
$37,103.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21,605.96
|
| Rate for Payer: UHC Exchange |
$30,301.55
|
| Rate for Payer: VA VA |
$21,605.96
|
|
|
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$39,620.38
|
|
|
Service Code
|
MSDRG 322
|
| Min. Negotiated Rate |
$13,493.69 |
| Max. Negotiated Rate |
$39,620.38 |
| Rate for Payer: Aetna Medicare |
$14,772.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,754.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,754.85
|
| Rate for Payer: BCBS MAPPO |
$14,203.88
|
| Rate for Payer: BCBS Trust/PPO |
$39,620.38
|
| Rate for Payer: BCN Commercial |
$39,620.38
|
| Rate for Payer: BCN Medicare Advantage |
$14,203.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,203.88
|
| Rate for Payer: Mclaren Medicare |
$14,203.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,914.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,334.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,624.27
|
| Rate for Payer: Nomi Health Commercial |
$22,742.70
|
| Rate for Payer: PACE Medicare |
$13,493.69
|
| Rate for Payer: PACE SWMI |
$14,203.88
|
| Rate for Payer: PHP Medicare Advantage |
$14,203.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,423.33
|
| Rate for Payer: Priority Health Medicare |
$14,203.88
|
| Rate for Payer: Priority Health Tiered Network |
$22,738.66
|
| Rate for Payer: Railroad Medicare Medicare |
$14,203.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,736.90
|
| Rate for Payer: UHC Core |
$24,042.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,203.88
|
| Rate for Payer: UHC Exchange |
$19,634.53
|
| Rate for Payer: VA VA |
$14,203.88
|
|
|
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$47,902.13
|
|
|
Service Code
|
MSDRG 250
|
| Min. Negotiated Rate |
$16,573.58 |
| Max. Negotiated Rate |
$47,902.13 |
| Rate for Payer: Aetna Medicare |
$18,143.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,807.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,807.34
|
| Rate for Payer: BCBS MAPPO |
$17,445.87
|
| Rate for Payer: BCBS Trust/PPO |
$47,902.13
|
| Rate for Payer: BCN Commercial |
$47,902.13
|
| Rate for Payer: BCN Medicare Advantage |
$17,445.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,445.87
|
| Rate for Payer: Mclaren Medicare |
$17,445.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,318.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,062.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,190.46
|
| Rate for Payer: Nomi Health Commercial |
$28,154.25
|
| Rate for Payer: PACE Medicare |
$16,573.58
|
| Rate for Payer: PACE SWMI |
$17,445.87
|
| Rate for Payer: PHP Medicare Advantage |
$17,445.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35,186.57
|
| Rate for Payer: Priority Health Medicare |
$17,445.87
|
| Rate for Payer: Priority Health Tiered Network |
$28,149.25
|
| Rate for Payer: Railroad Medicare Medicare |
$17,445.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,574.75
|
| Rate for Payer: UHC Core |
$29,762.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,445.87
|
| Rate for Payer: UHC Exchange |
$24,306.50
|
| Rate for Payer: VA VA |
$17,445.87
|
|
|
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$30,046.51
|
|
|
Service Code
|
MSDRG 251
|
| Min. Negotiated Rate |
$11,522.41 |
| Max. Negotiated Rate |
$30,046.51 |
| Rate for Payer: Aetna Medicare |
$12,614.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,161.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,161.06
|
| Rate for Payer: BCBS MAPPO |
$12,128.85
|
| Rate for Payer: BCBS Trust/PPO |
$30,046.51
|
| Rate for Payer: BCN Commercial |
$30,046.51
|
| Rate for Payer: BCN Medicare Advantage |
$12,128.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,128.85
|
| Rate for Payer: Mclaren Medicare |
$12,128.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,735.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,948.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,341.74
|
| Rate for Payer: Nomi Health Commercial |
$19,279.05
|
| Rate for Payer: PACE Medicare |
$11,522.41
|
| Rate for Payer: PACE SWMI |
$12,128.85
|
| Rate for Payer: PHP Medicare Advantage |
$12,128.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,094.54
|
| Rate for Payer: Priority Health Medicare |
$12,128.85
|
| Rate for Payer: Priority Health Tiered Network |
$19,275.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12,128.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,360.35
|
| Rate for Payer: UHC Core |
$20,380.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,128.85
|
| Rate for Payer: UHC Exchange |
$16,644.25
|
| Rate for Payer: VA VA |
$12,128.85
|
|
|
PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$63,826.59
|
|
|
Service Code
|
MSDRG 359
|
| Min. Negotiated Rate |
$25,795.62 |
| Max. Negotiated Rate |
$63,826.59 |
| Rate for Payer: Aetna Medicare |
$28,239.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,941.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,941.60
|
| Rate for Payer: BCBS MAPPO |
$27,153.28
|
| Rate for Payer: BCBS Trust/PPO |
$63,826.59
|
| Rate for Payer: BCN Commercial |
$63,826.59
|
| Rate for Payer: BCN Medicare Advantage |
$27,153.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,153.28
|
| Rate for Payer: Mclaren Medicare |
$27,153.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,510.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,226.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$29,868.61
|
| Rate for Payer: Nomi Health Commercial |
$44,357.94
|
| Rate for Payer: PACE Medicare |
$25,795.62
|
| Rate for Payer: PACE SWMI |
$27,153.28
|
| Rate for Payer: PHP Medicare Advantage |
$27,153.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$55,437.59
|
| Rate for Payer: Priority Health Medicare |
$27,153.28
|
| Rate for Payer: Priority Health Tiered Network |
$44,350.07
|
| Rate for Payer: Railroad Medicare Medicare |
$27,153.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,049.18
|
| Rate for Payer: UHC Core |
$46,892.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27,153.28
|
| Rate for Payer: UHC Exchange |
$38,295.69
|
| Rate for Payer: VA VA |
$27,153.28
|
|
|
PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$49,468.13
|
|
|
Service Code
|
MSDRG 360
|
| Min. Negotiated Rate |
$18,275.39 |
| Max. Negotiated Rate |
$49,468.13 |
| Rate for Payer: Aetna Medicare |
$20,006.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,046.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,046.56
|
| Rate for Payer: BCBS MAPPO |
$19,237.25
|
| Rate for Payer: BCBS Trust/PPO |
$49,468.13
|
| Rate for Payer: BCN Commercial |
$49,468.13
|
| Rate for Payer: BCN Medicare Advantage |
$19,237.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,237.25
|
| Rate for Payer: Mclaren Medicare |
$19,237.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,199.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,122.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,160.97
|
| Rate for Payer: Nomi Health Commercial |
$31,144.47
|
| Rate for Payer: PACE Medicare |
$18,275.39
|
| Rate for Payer: PACE SWMI |
$19,237.25
|
| Rate for Payer: PHP Medicare Advantage |
$19,237.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38,923.68
|
| Rate for Payer: Priority Health Medicare |
$19,237.25
|
| Rate for Payer: Priority Health Tiered Network |
$31,138.94
|
| Rate for Payer: Railroad Medicare Medicare |
$19,237.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39,353.09
|
| Rate for Payer: UHC Core |
$32,923.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,237.25
|
| Rate for Payer: UHC Exchange |
$26,888.06
|
| Rate for Payer: VA VA |
$19,237.25
|
|
|
PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$40,030.02
|
|
|
Service Code
|
MSDRG 318
|
| Min. Negotiated Rate |
$18,333.40 |
| Max. Negotiated Rate |
$40,030.02 |
| Rate for Payer: Aetna Medicare |
$20,070.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,122.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,122.90
|
| Rate for Payer: BCBS MAPPO |
$19,298.32
|
| Rate for Payer: BCBS Trust/PPO |
$40,030.02
|
| Rate for Payer: BCN Commercial |
$40,030.02
|
| Rate for Payer: BCN Medicare Advantage |
$19,298.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,298.32
|
| Rate for Payer: Mclaren Medicare |
$19,298.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,263.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,193.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,228.15
|
| Rate for Payer: Nomi Health Commercial |
$31,246.38
|
| Rate for Payer: PACE Medicare |
$18,333.40
|
| Rate for Payer: PACE SWMI |
$19,298.32
|
| Rate for Payer: PHP Medicare Advantage |
$19,298.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39,051.05
|
| Rate for Payer: Priority Health Medicare |
$19,298.32
|
| Rate for Payer: Priority Health Tiered Network |
$31,240.83
|
| Rate for Payer: Railroad Medicare Medicare |
$19,298.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39,481.86
|
| Rate for Payer: UHC Core |
$33,031.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,298.32
|
| Rate for Payer: UHC Exchange |
$26,976.04
|
| Rate for Payer: VA VA |
$19,298.32
|
|
|
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY; SACRAL NERVE (TRANSFORAMINAL PLACEMENT) INCLUDING IMAGE GUIDANCE, IF PERFORMED
|
Facility
|
OP
|
$20,535.59
|
|
|
Service Code
|
CPT 64561
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,321.09 |
| Max. Negotiated Rate |
$20,535.59 |
| Rate for Payer: Aetna Medicare |
$6,604.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,937.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,937.60
|
| Rate for Payer: BCBS Complete |
$3,487.46
|
| Rate for Payer: BCBS MAPPO |
$6,350.08
|
| Rate for Payer: BCBS Trust/PPO |
$5,942.22
|
| Rate for Payer: BCN Commercial |
$5,942.22
|
| Rate for Payer: BCN Medicare Advantage |
$6,350.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,350.08
|
| Rate for Payer: Mclaren Medicaid |
$3,321.09
|
| Rate for Payer: Mclaren Medicare |
$6,350.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,667.58
|
| Rate for Payer: Meridian Medicaid |
$6,667.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,302.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,985.09
|
| Rate for Payer: Nomi Health Commercial |
$19,050.24
|
| Rate for Payer: PACE Medicare |
$6,032.58
|
| Rate for Payer: PACE SWMI |
$6,350.08
|
| Rate for Payer: PHP Medicare Advantage |
$6,350.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,321.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,535.59
|
| Rate for Payer: Priority Health Medicare |
$6,350.08
|
| Rate for Payer: Priority Health Tiered Network |
$16,428.47
|
| Rate for Payer: Railroad Medicare Medicare |
$6,350.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,350.08
|
| Rate for Payer: UHC Medicaid |
$3,321.09
|
| Rate for Payer: UHCCP Medicaid |
$3,321.09
|
| Rate for Payer: VA VA |
$6,350.08
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$7,968.30
|
|
|
Service Code
|
APR-DRG 0301
|
| Min. Negotiated Rate |
$7,588.85 |
| Max. Negotiated Rate |
$7,968.30 |
| Rate for Payer: BCBS Complete |
$7,968.30
|
| Rate for Payer: Mclaren Medicaid |
$7,588.85
|
| Rate for Payer: Meridian Medicaid |
$7,968.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,588.85
|
| Rate for Payer: UHC Medicaid |
$7,588.85
|
| Rate for Payer: UHCCP Medicaid |
$7,588.85
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$23,615.37
|
|
|
Service Code
|
APR-DRG 0304
|
| Min. Negotiated Rate |
$22,490.83 |
| Max. Negotiated Rate |
$23,615.37 |
| Rate for Payer: BCBS Complete |
$23,615.37
|
| Rate for Payer: Mclaren Medicaid |
$22,490.83
|
| Rate for Payer: Meridian Medicaid |
$23,615.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,490.83
|
| Rate for Payer: UHC Medicaid |
$22,490.83
|
| Rate for Payer: UHCCP Medicaid |
$22,490.83
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$13,592.37
|
|
|
Service Code
|
APR-DRG 0302
|
| Min. Negotiated Rate |
$12,945.11 |
| Max. Negotiated Rate |
$13,592.37 |
| Rate for Payer: BCBS Complete |
$13,592.37
|
| Rate for Payer: Mclaren Medicaid |
$12,945.11
|
| Rate for Payer: Meridian Medicaid |
$13,592.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,945.11
|
| Rate for Payer: UHC Medicaid |
$12,945.11
|
| Rate for Payer: UHCCP Medicaid |
$12,945.11
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$17,470.74
|
|
|
Service Code
|
APR-DRG 0303
|
| Min. Negotiated Rate |
$16,638.80 |
| Max. Negotiated Rate |
$17,470.74 |
| Rate for Payer: BCBS Complete |
$17,470.74
|
| Rate for Payer: Mclaren Medicaid |
$16,638.80
|
| Rate for Payer: Meridian Medicaid |
$17,470.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,638.80
|
| Rate for Payer: UHC Medicaid |
$16,638.80
|
| Rate for Payer: UHCCP Medicaid |
$16,638.80
|
|
|
PERCUTANEOUS NEPHROLITHOTOMY OR PYELOLITHOTOMY, LITHOTRIPSY, STONE EXTRACTION, ANTEGRADE URETEROSCOPY, ANTEGRADE STENT PLACEMENT AND NEPHROSTOMY TUBE PLACEMENT, WHEN PERFORMED, INCLUDING IMAGING GUIDANCE; COMPLEX (EG, STONE[S] > 2 CM, BRANCHING STONES, STONES IN MULTIPLE LOCATIONS, URETER STONES, COMPLICATED ANATOMY)
|
Facility
|
OP
|
$30,503.59
|
|
|
Service Code
|
CPT 50081
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,933.16 |
| Max. Negotiated Rate |
$30,503.59 |
| Rate for Payer: Aetna Medicare |
$9,809.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,790.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,790.52
|
| Rate for Payer: BCBS Complete |
$5,180.29
|
| Rate for Payer: BCBS MAPPO |
$9,432.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,938.82
|
| Rate for Payer: BCN Commercial |
$5,938.82
|
| Rate for Payer: BCN Medicare Advantage |
$9,432.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,432.42
|
| Rate for Payer: Mclaren Medicaid |
$4,933.16
|
| Rate for Payer: Mclaren Medicare |
$9,432.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,904.04
|
| Rate for Payer: Meridian Medicaid |
$9,904.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,847.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,375.66
|
| Rate for Payer: Nomi Health Commercial |
$28,297.26
|
| Rate for Payer: PACE Medicare |
$8,960.80
|
| Rate for Payer: PACE SWMI |
$9,432.42
|
| Rate for Payer: PHP Medicare Advantage |
$9,432.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,933.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30,503.59
|
| Rate for Payer: Priority Health Medicare |
$9,432.42
|
| Rate for Payer: Priority Health Tiered Network |
$24,402.87
|
| Rate for Payer: Railroad Medicare Medicare |
$9,432.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,432.42
|
| Rate for Payer: UHC Medicaid |
$4,933.16
|
| Rate for Payer: UHCCP Medicaid |
$4,933.16
|
| Rate for Payer: VA VA |
$9,432.42
|
|
|
PERCUTANEOUS NEPHROLITHOTOMY OR PYELOLITHOTOMY, LITHOTRIPSY, STONE EXTRACTION, ANTEGRADE URETEROSCOPY, ANTEGRADE STENT PLACEMENT AND NEPHROSTOMY TUBE PLACEMENT, WHEN PERFORMED, INCLUDING IMAGING GUIDANCE; SIMPLE (EG, STONE[S] UP TO 2 CM IN SINGLE LOCATION OF KIDNEY OR RENAL PELVIS, NONBRANCHING STONES)
|
Facility
|
OP
|
$30,503.59
|
|
|
Service Code
|
CPT 50080
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,933.16 |
| Max. Negotiated Rate |
$30,503.59 |
| Rate for Payer: Aetna Medicare |
$9,809.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,790.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,790.52
|
| Rate for Payer: BCBS Complete |
$5,180.29
|
| Rate for Payer: BCBS MAPPO |
$9,432.42
|
| Rate for Payer: BCBS Trust/PPO |
$4,981.77
|
| Rate for Payer: BCN Commercial |
$4,981.77
|
| Rate for Payer: BCN Medicare Advantage |
$9,432.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,432.42
|
| Rate for Payer: Mclaren Medicaid |
$4,933.16
|
| Rate for Payer: Mclaren Medicare |
$9,432.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,904.04
|
| Rate for Payer: Meridian Medicaid |
$9,904.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,847.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,375.66
|
| Rate for Payer: Nomi Health Commercial |
$28,297.26
|
| Rate for Payer: PACE Medicare |
$8,960.80
|
| Rate for Payer: PACE SWMI |
$9,432.42
|
| Rate for Payer: PHP Medicare Advantage |
$9,432.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,933.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30,503.59
|
| Rate for Payer: Priority Health Medicare |
$9,432.42
|
| Rate for Payer: Priority Health Tiered Network |
$24,402.87
|
| Rate for Payer: Railroad Medicare Medicare |
$9,432.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,432.42
|
| Rate for Payer: UHC Medicaid |
$4,933.16
|
| Rate for Payer: UHCCP Medicaid |
$4,933.16
|
| Rate for Payer: VA VA |
$9,432.42
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE, EACH BONE
|
Facility
|
OP
|
$10,543.31
|
|
|
Service Code
|
CPT 26608
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.66
|
| Rate for Payer: BCN Commercial |
$1,875.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Mclaren Medicaid |
$1,705.10
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$17,992.45
|
|
|
Service Code
|
APR-DRG 1831
|
| Min. Negotiated Rate |
$17,135.66 |
| Max. Negotiated Rate |
$17,992.45 |
| Rate for Payer: BCBS Complete |
$17,992.45
|
| Rate for Payer: Mclaren Medicaid |
$17,135.66
|
| Rate for Payer: Meridian Medicaid |
$17,992.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,135.66
|
| Rate for Payer: UHC Medicaid |
$17,135.66
|
| Rate for Payer: UHCCP Medicaid |
$17,135.66
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$24,815.86
|
|
|
Service Code
|
APR-DRG 1833
|
| Min. Negotiated Rate |
$23,634.16 |
| Max. Negotiated Rate |
$24,815.86 |
| Rate for Payer: BCBS Complete |
$24,815.86
|
| Rate for Payer: Mclaren Medicaid |
$23,634.16
|
| Rate for Payer: Meridian Medicaid |
$24,815.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,634.16
|
| Rate for Payer: UHC Medicaid |
$23,634.16
|
| Rate for Payer: UHCCP Medicaid |
$23,634.16
|
|
