|
PERITON. DIALYSIS SOLN 8-4.25 % DEXTROSE CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
IP
|
$118.65
|
|
|
Service Code
|
NDC 49230021294
|
| Hospital Charge Code |
27803
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$74.75 |
| Max. Negotiated Rate |
$106.78 |
| Rate for Payer: Aetna Commercial |
$100.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.12
|
| Rate for Payer: Cash Price |
$94.92
|
| Rate for Payer: Cofinity Advantage |
$83.06
|
| Rate for Payer: Cofinity Commercial |
$102.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.92
|
| Rate for Payer: Healthscope Commercial |
$106.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.99
|
| Rate for Payer: PHP Commercial |
$100.85
|
| Rate for Payer: Priority Health SBD |
$74.75
|
|
|
PERITONEAL ADHESIOLYSIS
|
Facility
|
IP
|
$28,111.77
|
|
|
Service Code
|
APR-DRG 2244
|
| Min. Negotiated Rate |
$26,773.11 |
| Max. Negotiated Rate |
$28,111.77 |
| Rate for Payer: BCBS Complete |
$28,111.77
|
| Rate for Payer: Mclaren Medicaid |
$26,773.11
|
| Rate for Payer: Meridian Medicaid |
$28,111.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,773.11
|
| Rate for Payer: UHC Medicaid |
$26,773.11
|
| Rate for Payer: UHCCP Medicaid |
$26,773.11
|
|
|
PERITONEAL ADHESIOLYSIS
|
Facility
|
IP
|
$11,609.90
|
|
|
Service Code
|
APR-DRG 2242
|
| Min. Negotiated Rate |
$11,057.05 |
| Max. Negotiated Rate |
$11,609.90 |
| Rate for Payer: BCBS Complete |
$11,609.90
|
| Rate for Payer: Mclaren Medicaid |
$11,057.05
|
| Rate for Payer: Meridian Medicaid |
$11,609.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,057.05
|
| Rate for Payer: UHC Medicaid |
$11,057.05
|
| Rate for Payer: UHCCP Medicaid |
$11,057.05
|
|
|
PERITONEAL ADHESIOLYSIS
|
Facility
|
IP
|
$8,858.63
|
|
|
Service Code
|
APR-DRG 2241
|
| Min. Negotiated Rate |
$8,436.79 |
| Max. Negotiated Rate |
$8,858.63 |
| Rate for Payer: BCBS Complete |
$8,858.63
|
| Rate for Payer: Mclaren Medicaid |
$8,436.79
|
| Rate for Payer: Meridian Medicaid |
$8,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,436.79
|
| Rate for Payer: UHC Medicaid |
$8,436.79
|
| Rate for Payer: UHCCP Medicaid |
$8,436.79
|
|
|
PERITONEAL ADHESIOLYSIS
|
Facility
|
IP
|
$15,048.55
|
|
|
Service Code
|
APR-DRG 2243
|
| Min. Negotiated Rate |
$14,331.95 |
| Max. Negotiated Rate |
$15,048.55 |
| Rate for Payer: BCBS Complete |
$15,048.55
|
| Rate for Payer: Mclaren Medicaid |
$14,331.95
|
| Rate for Payer: Meridian Medicaid |
$15,048.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,331.95
|
| Rate for Payer: UHC Medicaid |
$14,331.95
|
| Rate for Payer: UHCCP Medicaid |
$14,331.95
|
|
|
PERITONEAL ADHESIOLYSIS WITH CC
|
Facility
|
IP
|
$35,655.07
|
|
|
Service Code
|
MSDRG 336
|
| Min. Negotiated Rate |
$16,031.73 |
| Max. Negotiated Rate |
$35,655.07 |
| Rate for Payer: Aetna Medicare |
$17,550.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,094.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,094.39
|
| Rate for Payer: BCBS MAPPO |
$16,875.51
|
| Rate for Payer: BCBS Trust/PPO |
$35,655.07
|
| Rate for Payer: BCN Commercial |
$35,655.07
|
| Rate for Payer: BCN Medicare Advantage |
$16,875.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,875.51
|
| Rate for Payer: Mclaren Medicare |
$16,875.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,719.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,406.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,563.06
|
| Rate for Payer: Nomi Health Commercial |
$27,202.23
|
| Rate for Payer: PACE Medicare |
$16,031.73
|
| Rate for Payer: PACE SWMI |
$16,875.51
|
| Rate for Payer: PHP Medicare Advantage |
$16,875.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33,996.76
|
| Rate for Payer: Priority Health Medicare |
$16,875.51
|
| Rate for Payer: Priority Health Tiered Network |
$27,197.40
|
| Rate for Payer: Railroad Medicare Medicare |
$16,875.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,371.81
|
| Rate for Payer: UHC Core |
$28,756.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,875.51
|
| Rate for Payer: UHC Exchange |
$23,484.59
|
| Rate for Payer: VA VA |
$16,875.51
|
|
|
PERITONEAL ADHESIOLYSIS WITH MCC
|
Facility
|
IP
|
$58,205.67
|
|
|
Service Code
|
MSDRG 335
|
| Min. Negotiated Rate |
$26,766.94 |
| Max. Negotiated Rate |
$58,205.67 |
| Rate for Payer: Aetna Medicare |
$29,302.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,219.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,219.66
|
| Rate for Payer: BCBS MAPPO |
$28,175.73
|
| Rate for Payer: BCBS Trust/PPO |
$55,004.12
|
| Rate for Payer: BCN Commercial |
$55,004.12
|
| Rate for Payer: BCN Medicare Advantage |
$28,175.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,175.73
|
| Rate for Payer: Mclaren Medicare |
$28,175.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,584.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,402.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$30,993.30
|
| Rate for Payer: Nomi Health Commercial |
$46,064.61
|
| Rate for Payer: PACE Medicare |
$26,766.94
|
| Rate for Payer: PACE SWMI |
$28,175.73
|
| Rate for Payer: PHP Medicare Advantage |
$28,175.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57,570.55
|
| Rate for Payer: Priority Health Medicare |
$28,175.73
|
| Rate for Payer: Priority Health Tiered Network |
$46,056.43
|
| Rate for Payer: Railroad Medicare Medicare |
$28,175.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,205.67
|
| Rate for Payer: UHC Core |
$48,696.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28,175.73
|
| Rate for Payer: UHC Exchange |
$39,769.11
|
| Rate for Payer: VA VA |
$28,175.73
|
|
|
PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,435.08
|
|
|
Service Code
|
MSDRG 337
|
| Min. Negotiated Rate |
$11,819.74 |
| Max. Negotiated Rate |
$30,435.08 |
| Rate for Payer: BCN Commercial |
$30,435.08
|
| Rate for Payer: Aetna Medicare |
$12,939.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,552.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,552.29
|
| Rate for Payer: BCBS MAPPO |
$12,441.83
|
| Rate for Payer: BCBS Trust/PPO |
$30,435.08
|
| Rate for Payer: BCN Medicare Advantage |
$12,441.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,441.83
|
| Rate for Payer: Mclaren Medicare |
$12,441.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,063.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,308.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,686.01
|
| Rate for Payer: Nomi Health Commercial |
$19,801.50
|
| Rate for Payer: PACE Medicare |
$11,819.74
|
| Rate for Payer: PACE SWMI |
$12,441.83
|
| Rate for Payer: PHP Medicare Advantage |
$12,441.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,747.48
|
| Rate for Payer: Priority Health Medicare |
$12,441.83
|
| Rate for Payer: Priority Health Tiered Network |
$19,797.98
|
| Rate for Payer: Railroad Medicare Medicare |
$12,441.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,020.50
|
| Rate for Payer: UHC Core |
$20,932.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,441.83
|
| Rate for Payer: UHC Exchange |
$17,095.29
|
| Rate for Payer: VA VA |
$12,441.83
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
IP
|
$162.72
|
|
|
Service Code
|
NDC 49230020995
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$102.51 |
| Max. Negotiated Rate |
$146.45 |
| Rate for Payer: Aetna Commercial |
$138.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.77
|
| Rate for Payer: Cash Price |
$130.18
|
| Rate for Payer: Cofinity Advantage |
$113.90
|
| Rate for Payer: Cofinity Commercial |
$139.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.18
|
| Rate for Payer: Healthscope Commercial |
$146.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.04
|
| Rate for Payer: PHP Commercial |
$138.31
|
| Rate for Payer: Priority Health SBD |
$102.51
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
OP
|
$162.72
|
|
|
Service Code
|
NDC 49230020995
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$63.95 |
| Max. Negotiated Rate |
$146.45 |
| Rate for Payer: Aetna Commercial |
$138.31
|
| Rate for Payer: Aetna Medicare |
$81.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.77
|
| Rate for Payer: BCBS Complete |
$65.09
|
| Rate for Payer: Cash Price |
$130.18
|
| Rate for Payer: Cofinity Advantage |
$113.90
|
| Rate for Payer: Cofinity Commercial |
$139.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.18
|
| Rate for Payer: Healthscope Commercial |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.04
|
| Rate for Payer: PHP Commercial |
$138.31
|
| Rate for Payer: Priority Health SBD |
$102.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.77
|
| Rate for Payer: UHC Core |
$84.78
|
| Rate for Payer: UHC Exchange |
$63.95
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
OP
|
$118.65
|
|
|
Service Code
|
NDC 49230020994
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$46.63 |
| Max. Negotiated Rate |
$106.78 |
| Rate for Payer: Aetna Commercial |
$100.85
|
| Rate for Payer: Aetna Medicare |
$59.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.12
|
| Rate for Payer: BCBS Complete |
$47.46
|
| Rate for Payer: Cash Price |
$94.92
|
| Rate for Payer: Cofinity Advantage |
$83.06
|
| Rate for Payer: Cofinity Commercial |
$102.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.92
|
| Rate for Payer: Healthscope Commercial |
$106.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.99
|
| Rate for Payer: PHP Commercial |
$100.85
|
| Rate for Payer: Priority Health SBD |
$74.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.12
|
| Rate for Payer: UHC Core |
$61.82
|
| Rate for Payer: UHC Exchange |
$46.63
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
OP
|
$135.60
|
|
|
Service Code
|
NDC 49230020992
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$53.29 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna Commercial |
$115.26
|
| Rate for Payer: Aetna Medicare |
$67.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.14
|
| Rate for Payer: BCBS Complete |
$54.24
|
| Rate for Payer: Cash Price |
$108.48
|
| Rate for Payer: Cofinity Advantage |
$94.92
|
| Rate for Payer: Cofinity Commercial |
$116.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.48
|
| Rate for Payer: Healthscope Commercial |
$122.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.70
|
| Rate for Payer: PHP Commercial |
$115.26
|
| Rate for Payer: Priority Health SBD |
$85.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.14
|
| Rate for Payer: UHC Core |
$70.65
|
| Rate for Payer: UHC Exchange |
$53.29
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
IP
|
$135.60
|
|
|
Service Code
|
NDC 49230020992
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$85.43 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna Commercial |
$115.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.14
|
| Rate for Payer: Cash Price |
$108.48
|
| Rate for Payer: Cofinity Advantage |
$94.92
|
| Rate for Payer: Cofinity Commercial |
$116.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.48
|
| Rate for Payer: Healthscope Commercial |
$122.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.70
|
| Rate for Payer: PHP Commercial |
$115.26
|
| Rate for Payer: Priority Health SBD |
$85.43
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
IP
|
$118.65
|
|
|
Service Code
|
NDC 49230020994
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$74.75 |
| Max. Negotiated Rate |
$106.78 |
| Rate for Payer: Aetna Commercial |
$100.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.12
|
| Rate for Payer: Cash Price |
$94.92
|
| Rate for Payer: Cofinity Advantage |
$83.06
|
| Rate for Payer: Cofinity Commercial |
$102.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.92
|
| Rate for Payer: Healthscope Commercial |
$106.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.99
|
| Rate for Payer: PHP Commercial |
$100.85
|
| Rate for Payer: Priority Health SBD |
$74.75
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$16,803.42
|
|
|
Service Code
|
APR-DRG 1702
|
| Min. Negotiated Rate |
$16,003.26 |
| Max. Negotiated Rate |
$16,803.42 |
| Rate for Payer: BCBS Complete |
$16,803.42
|
| Rate for Payer: Mclaren Medicaid |
$16,003.26
|
| Rate for Payer: Meridian Medicaid |
$16,803.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,003.26
|
| Rate for Payer: UHC Medicaid |
$16,003.26
|
| Rate for Payer: UHCCP Medicaid |
$16,003.26
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$12,446.34
|
|
|
Service Code
|
APR-DRG 1701
|
| Min. Negotiated Rate |
$11,853.66 |
| Max. Negotiated Rate |
$12,446.34 |
| Rate for Payer: BCBS Complete |
$12,446.34
|
| Rate for Payer: Mclaren Medicaid |
$11,853.66
|
| Rate for Payer: Meridian Medicaid |
$12,446.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,853.66
|
| Rate for Payer: UHC Medicaid |
$11,853.66
|
| Rate for Payer: UHCCP Medicaid |
$11,853.66
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$24,413.98
|
|
|
Service Code
|
APR-DRG 1703
|
| Min. Negotiated Rate |
$23,251.41 |
| Max. Negotiated Rate |
$24,413.98 |
| Rate for Payer: BCBS Complete |
$24,413.98
|
| Rate for Payer: Mclaren Medicaid |
$23,251.41
|
| Rate for Payer: Meridian Medicaid |
$24,413.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,251.41
|
| Rate for Payer: UHC Medicaid |
$23,251.41
|
| Rate for Payer: UHCCP Medicaid |
$23,251.41
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$40,278.91
|
|
|
Service Code
|
APR-DRG 1704
|
| Min. Negotiated Rate |
$38,360.87 |
| Max. Negotiated Rate |
$40,278.91 |
| Rate for Payer: BCBS Complete |
$40,278.91
|
| Rate for Payer: Mclaren Medicaid |
$38,360.87
|
| Rate for Payer: Meridian Medicaid |
$40,278.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$38,360.87
|
| Rate for Payer: UHC Medicaid |
$38,360.87
|
| Rate for Payer: UHCCP Medicaid |
$38,360.87
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC
|
Facility
|
IP
|
$41,532.81
|
|
|
Service Code
|
MSDRG 243
|
| Min. Negotiated Rate |
$16,194.73 |
| Max. Negotiated Rate |
$41,532.81 |
| Rate for Payer: Aetna Medicare |
$17,728.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,308.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,308.85
|
| Rate for Payer: BCBS MAPPO |
$17,047.08
|
| Rate for Payer: BCBS Trust/PPO |
$41,532.81
|
| Rate for Payer: BCN Commercial |
$41,532.81
|
| Rate for Payer: BCN Medicare Advantage |
$17,047.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,047.08
|
| Rate for Payer: Mclaren Medicare |
$17,047.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,899.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,604.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,751.79
|
| Rate for Payer: Nomi Health Commercial |
$27,488.61
|
| Rate for Payer: PACE Medicare |
$16,194.73
|
| Rate for Payer: PACE SWMI |
$17,047.08
|
| Rate for Payer: PHP Medicare Advantage |
$17,047.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34,354.67
|
| Rate for Payer: Priority Health Medicare |
$17,047.08
|
| Rate for Payer: Priority Health Tiered Network |
$27,483.73
|
| Rate for Payer: Railroad Medicare Medicare |
$17,047.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,733.67
|
| Rate for Payer: UHC Core |
$29,059.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,047.08
|
| Rate for Payer: UHC Exchange |
$23,731.83
|
| Rate for Payer: VA VA |
$17,047.08
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC
|
Facility
|
IP
|
$62,501.70
|
|
|
Service Code
|
MSDRG 242
|
| Min. Negotiated Rate |
$23,991.00 |
| Max. Negotiated Rate |
$62,501.70 |
| Rate for Payer: Aetna Medicare |
$26,263.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,567.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,567.10
|
| Rate for Payer: BCBS MAPPO |
$25,253.68
|
| Rate for Payer: BCBS Trust/PPO |
$62,501.70
|
| Rate for Payer: BCN Commercial |
$62,501.70
|
| Rate for Payer: BCN Medicare Advantage |
$25,253.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,253.68
|
| Rate for Payer: Mclaren Medicare |
$25,253.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,516.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,041.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$27,779.05
|
| Rate for Payer: Nomi Health Commercial |
$41,187.12
|
| Rate for Payer: PACE Medicare |
$23,991.00
|
| Rate for Payer: PACE SWMI |
$25,253.68
|
| Rate for Payer: PHP Medicare Advantage |
$25,253.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51,474.77
|
| Rate for Payer: Priority Health Medicare |
$25,253.68
|
| Rate for Payer: Priority Health Tiered Network |
$41,179.81
|
| Rate for Payer: Railroad Medicare Medicare |
$25,253.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52,042.64
|
| Rate for Payer: UHC Core |
$43,540.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25,253.68
|
| Rate for Payer: UHC Exchange |
$35,558.21
|
| Rate for Payer: VA VA |
$25,253.68
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$12,632.09
|
|
|
Service Code
|
APR-DRG 1712
|
| Min. Negotiated Rate |
$12,030.56 |
| Max. Negotiated Rate |
$12,632.09 |
| Rate for Payer: BCBS Complete |
$12,632.09
|
| Rate for Payer: Mclaren Medicaid |
$12,030.56
|
| Rate for Payer: Meridian Medicaid |
$12,632.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,030.56
|
| Rate for Payer: UHC Medicaid |
$12,030.56
|
| Rate for Payer: UHCCP Medicaid |
$12,030.56
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$17,358.95
|
|
|
Service Code
|
APR-DRG 1713
|
| Min. Negotiated Rate |
$16,532.33 |
| Max. Negotiated Rate |
$17,358.95 |
| Rate for Payer: BCBS Complete |
$17,358.95
|
| Rate for Payer: Mclaren Medicaid |
$16,532.33
|
| Rate for Payer: Meridian Medicaid |
$17,358.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,532.33
|
| Rate for Payer: UHC Medicaid |
$16,532.33
|
| Rate for Payer: UHCCP Medicaid |
$16,532.33
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$9,742.66
|
|
|
Service Code
|
APR-DRG 1711
|
| Min. Negotiated Rate |
$9,278.72 |
| Max. Negotiated Rate |
$9,742.66 |
| Rate for Payer: BCBS Complete |
$9,742.66
|
| Rate for Payer: Mclaren Medicaid |
$9,278.72
|
| Rate for Payer: Meridian Medicaid |
$9,742.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,278.72
|
| Rate for Payer: UHC Medicaid |
$9,278.72
|
| Rate for Payer: UHCCP Medicaid |
$9,278.72
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$24,852.56
|
|
|
Service Code
|
APR-DRG 1714
|
| Min. Negotiated Rate |
$23,669.10 |
| Max. Negotiated Rate |
$24,852.56 |
| Rate for Payer: BCBS Complete |
$24,852.56
|
| Rate for Payer: Mclaren Medicaid |
$23,669.10
|
| Rate for Payer: Meridian Medicaid |
$24,852.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,669.10
|
| Rate for Payer: UHC Medicaid |
$23,669.10
|
| Rate for Payer: UHCCP Medicaid |
$23,669.10
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$38,765.99
|
|
|
Service Code
|
MSDRG 244
|
| Min. Negotiated Rate |
$13,820.38 |
| Max. Negotiated Rate |
$38,765.99 |
| Rate for Payer: Aetna Medicare |
$15,129.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,184.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,184.71
|
| Rate for Payer: BCBS MAPPO |
$14,547.77
|
| Rate for Payer: BCBS Trust/PPO |
$38,765.99
|
| Rate for Payer: BCN Commercial |
$38,765.99
|
| Rate for Payer: BCN Medicare Advantage |
$14,547.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,547.77
|
| Rate for Payer: Mclaren Medicare |
$14,547.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,275.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,729.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,002.55
|
| Rate for Payer: Nomi Health Commercial |
$23,316.75
|
| Rate for Payer: PACE Medicare |
$13,820.38
|
| Rate for Payer: PACE SWMI |
$14,547.77
|
| Rate for Payer: PHP Medicare Advantage |
$14,547.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29,140.77
|
| Rate for Payer: Priority Health Medicare |
$14,547.77
|
| Rate for Payer: Priority Health Tiered Network |
$23,312.61
|
| Rate for Payer: Railroad Medicare Medicare |
$14,547.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,462.25
|
| Rate for Payer: UHC Core |
$24,648.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,547.77
|
| Rate for Payer: UHC Exchange |
$20,130.13
|
| Rate for Payer: VA VA |
$14,547.77
|
|
