|
SKIN DEBRIDEMENT WITH CC
|
Facility
|
IP
|
$26,418.87
|
|
|
Service Code
|
MS-DRG 571
|
| Min. Negotiated Rate |
$12,043.58 |
| Max. Negotiated Rate |
$26,418.87 |
| Rate for Payer: Aetna Medicare |
$13,184.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,846.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,846.81
|
| Rate for Payer: BCBS MAPPO |
$12,677.45
|
| Rate for Payer: BCBS Trust/PPO |
$26,418.87
|
| Rate for Payer: BCN Medicare Advantage |
$12,677.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,677.45
|
| Rate for Payer: Mclaren Medicare |
$12,677.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,311.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,579.07
|
| Rate for Payer: PACE Medicare |
$12,043.58
|
| Rate for Payer: PACE SWMI |
$12,677.45
|
| Rate for Payer: PHP Medicare Advantage |
$12,677.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,278.63
|
| Rate for Payer: Priority Health Medicare |
$12,677.45
|
| Rate for Payer: Priority Health Narrow Network |
$19,422.90
|
| Rate for Payer: Railroad Medicare Medicare |
$12,677.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,808.24
|
| Rate for Payer: UHC Core |
$15,836.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,677.45
|
| Rate for Payer: UHC Exchange |
$16,961.30
|
| Rate for Payer: UHC Medicare Advantage |
$13,057.77
|
| Rate for Payer: VA VA |
$12,677.45
|
|
|
SKIN DEBRIDEMENT WITH MCC
|
Facility
|
IP
|
$44,575.24
|
|
|
Service Code
|
MS-DRG 570
|
| Min. Negotiated Rate |
$20,460.92 |
| Max. Negotiated Rate |
$44,575.24 |
| Rate for Payer: Aetna Medicare |
$22,399.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,922.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,922.26
|
| Rate for Payer: BCBS MAPPO |
$21,537.81
|
| Rate for Payer: BCBS Trust/PPO |
$33,860.78
|
| Rate for Payer: BCN Medicare Advantage |
$21,537.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,537.81
|
| Rate for Payer: Mclaren Medicare |
$21,537.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,614.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,768.48
|
| Rate for Payer: PACE Medicare |
$20,460.92
|
| Rate for Payer: PACE SWMI |
$21,537.81
|
| Rate for Payer: PHP Medicare Advantage |
$21,537.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41,933.34
|
| Rate for Payer: Priority Health Medicare |
$21,537.81
|
| Rate for Payer: Priority Health Narrow Network |
$33,546.67
|
| Rate for Payer: Railroad Medicare Medicare |
$21,537.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,575.24
|
| Rate for Payer: UHC Core |
$27,351.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,537.81
|
| Rate for Payer: UHC Exchange |
$29,295.06
|
| Rate for Payer: UHC Medicare Advantage |
$22,183.94
|
| Rate for Payer: VA VA |
$21,537.81
|
|
|
SKIN DEBRIDEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$17,793.38
|
|
|
Service Code
|
MS-DRG 572
|
| Min. Negotiated Rate |
$8,264.90 |
| Max. Negotiated Rate |
$17,793.38 |
| Rate for Payer: Aetna Medicare |
$9,047.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,874.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,874.88
|
| Rate for Payer: BCBS MAPPO |
$8,699.90
|
| Rate for Payer: BCBS Trust/PPO |
$17,793.38
|
| Rate for Payer: BCN Medicare Advantage |
$8,699.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,699.90
|
| Rate for Payer: Mclaren Medicare |
$8,699.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,134.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,004.88
|
| Rate for Payer: PACE Medicare |
$8,264.90
|
| Rate for Payer: PACE SWMI |
$8,699.90
|
| Rate for Payer: PHP Medicare Advantage |
$8,699.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,353.17
|
| Rate for Payer: Priority Health Medicare |
$8,699.90
|
| Rate for Payer: Priority Health Narrow Network |
$13,082.54
|
| Rate for Payer: Railroad Medicare Medicare |
$8,699.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,383.46
|
| Rate for Payer: UHC Core |
$10,666.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,699.90
|
| Rate for Payer: UHC Exchange |
$11,424.49
|
| Rate for Payer: UHC Medicare Advantage |
$8,960.90
|
| Rate for Payer: VA VA |
$8,699.90
|
|
|
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$64,159.81
|
|
|
Service Code
|
MS-DRG 577
|
| Min. Negotiated Rate |
$18,592.45 |
| Max. Negotiated Rate |
$64,159.81 |
| Rate for Payer: Aetna Medicare |
$20,353.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,463.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,463.75
|
| Rate for Payer: BCBS MAPPO |
$19,571.00
|
| Rate for Payer: BCBS Trust/PPO |
$64,159.81
|
| Rate for Payer: BCN Medicare Advantage |
$19,571.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,571.00
|
| Rate for Payer: Mclaren Medicare |
$19,571.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20,549.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,506.65
|
| Rate for Payer: PACE Medicare |
$18,592.45
|
| Rate for Payer: PACE SWMI |
$19,571.00
|
| Rate for Payer: PHP Medicare Advantage |
$19,571.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38,014.37
|
| Rate for Payer: Priority Health Medicare |
$19,571.00
|
| Rate for Payer: Priority Health Narrow Network |
$30,411.50
|
| Rate for Payer: Railroad Medicare Medicare |
$19,571.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,409.37
|
| Rate for Payer: UHC Core |
$24,795.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,571.00
|
| Rate for Payer: UHC Exchange |
$26,557.23
|
| Rate for Payer: UHC Medicare Advantage |
$20,158.13
|
| Rate for Payer: VA VA |
$19,571.00
|
|
|
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$100,043.01
|
|
|
Service Code
|
MS-DRG 576
|
| Min. Negotiated Rate |
$39,350.17 |
| Max. Negotiated Rate |
$100,043.01 |
| Rate for Payer: Aetna Medicare |
$43,078.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51,776.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51,776.54
|
| Rate for Payer: BCBS MAPPO |
$41,421.23
|
| Rate for Payer: BCBS Trust/PPO |
$100,043.01
|
| Rate for Payer: BCN Medicare Advantage |
$41,421.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41,421.23
|
| Rate for Payer: Mclaren Medicare |
$41,421.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43,492.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47,634.41
|
| Rate for Payer: PACE Medicare |
$39,350.17
|
| Rate for Payer: PACE SWMI |
$41,421.23
|
| Rate for Payer: PHP Medicare Advantage |
$41,421.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81,552.03
|
| Rate for Payer: Priority Health Medicare |
$41,421.23
|
| Rate for Payer: Priority Health Narrow Network |
$65,241.62
|
| Rate for Payer: Railroad Medicare Medicare |
$41,421.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86,690.01
|
| Rate for Payer: UHC Core |
$53,193.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$41,421.23
|
| Rate for Payer: UHC Exchange |
$56,973.08
|
| Rate for Payer: UHC Medicare Advantage |
$42,663.87
|
| Rate for Payer: VA VA |
$41,421.23
|
|
|
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$31,869.10
|
|
|
Service Code
|
MS-DRG 578
|
| Min. Negotiated Rate |
$11,486.66 |
| Max. Negotiated Rate |
$31,869.10 |
| Rate for Payer: Aetna Medicare |
$12,574.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,114.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,114.02
|
| Rate for Payer: BCBS MAPPO |
$12,091.22
|
| Rate for Payer: BCBS Trust/PPO |
$31,869.10
|
| Rate for Payer: BCN Medicare Advantage |
$12,091.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,091.22
|
| Rate for Payer: Mclaren Medicare |
$12,091.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,695.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,904.90
|
| Rate for Payer: PACE Medicare |
$11,486.66
|
| Rate for Payer: PACE SWMI |
$12,091.22
|
| Rate for Payer: PHP Medicare Advantage |
$12,091.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,110.55
|
| Rate for Payer: Priority Health Medicare |
$12,091.22
|
| Rate for Payer: Priority Health Narrow Network |
$18,488.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12,091.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,566.57
|
| Rate for Payer: UHC Core |
$15,074.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,091.22
|
| Rate for Payer: UHC Exchange |
$16,145.26
|
| Rate for Payer: UHC Medicare Advantage |
$12,453.96
|
| Rate for Payer: VA VA |
$12,091.22
|
|
|
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$51,952.07
|
|
|
Service Code
|
MS-DRG 574
|
| Min. Negotiated Rate |
$23,769.57 |
| Max. Negotiated Rate |
$51,952.07 |
| Rate for Payer: Aetna Medicare |
$26,021.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,275.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,275.75
|
| Rate for Payer: BCBS MAPPO |
$25,020.60
|
| Rate for Payer: BCBS Trust/PPO |
$38,915.74
|
| Rate for Payer: BCN Medicare Advantage |
$25,020.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,020.60
|
| Rate for Payer: Mclaren Medicare |
$25,020.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26,271.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,773.69
|
| Rate for Payer: PACE Medicare |
$23,769.57
|
| Rate for Payer: PACE SWMI |
$25,020.60
|
| Rate for Payer: PHP Medicare Advantage |
$25,020.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48,872.96
|
| Rate for Payer: Priority Health Medicare |
$25,020.60
|
| Rate for Payer: Priority Health Narrow Network |
$39,098.37
|
| Rate for Payer: Railroad Medicare Medicare |
$25,020.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51,952.07
|
| Rate for Payer: UHC Core |
$31,878.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,020.60
|
| Rate for Payer: UHC Exchange |
$34,143.15
|
| Rate for Payer: UHC Medicare Advantage |
$25,771.22
|
| Rate for Payer: VA VA |
$25,020.60
|
|
|
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$113,556.58
|
|
|
Service Code
|
MS-DRG 573
|
| Min. Negotiated Rate |
$43,010.49 |
| Max. Negotiated Rate |
$113,556.58 |
| Rate for Payer: Aetna Medicare |
$47,085.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56,592.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56,592.75
|
| Rate for Payer: BCBS MAPPO |
$45,274.20
|
| Rate for Payer: BCBS Trust/PPO |
$113,556.58
|
| Rate for Payer: BCN Medicare Advantage |
$45,274.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45,274.20
|
| Rate for Payer: Mclaren Medicare |
$45,274.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47,537.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52,065.33
|
| Rate for Payer: PACE Medicare |
$43,010.49
|
| Rate for Payer: PACE SWMI |
$45,274.20
|
| Rate for Payer: PHP Medicare Advantage |
$45,274.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89,229.24
|
| Rate for Payer: Priority Health Medicare |
$45,274.20
|
| Rate for Payer: Priority Health Narrow Network |
$71,383.39
|
| Rate for Payer: Railroad Medicare Medicare |
$45,274.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94,850.90
|
| Rate for Payer: UHC Core |
$58,201.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$45,274.20
|
| Rate for Payer: UHC Exchange |
$62,336.45
|
| Rate for Payer: UHC Medicare Advantage |
$46,632.43
|
| Rate for Payer: VA VA |
$45,274.20
|
|
|
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$31,209.68
|
|
|
Service Code
|
MS-DRG 575
|
| Min. Negotiated Rate |
$14,466.23 |
| Max. Negotiated Rate |
$31,209.68 |
| Rate for Payer: Aetna Medicare |
$15,836.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,034.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,034.51
|
| Rate for Payer: BCBS MAPPO |
$15,227.61
|
| Rate for Payer: BCBS Trust/PPO |
$23,377.55
|
| Rate for Payer: BCN Medicare Advantage |
$15,227.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,227.61
|
| Rate for Payer: Mclaren Medicare |
$15,227.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,988.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,511.75
|
| Rate for Payer: PACE Medicare |
$14,466.23
|
| Rate for Payer: PACE SWMI |
$15,227.61
|
| Rate for Payer: PHP Medicare Advantage |
$15,227.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29,359.94
|
| Rate for Payer: Priority Health Medicare |
$15,227.61
|
| Rate for Payer: Priority Health Narrow Network |
$23,487.95
|
| Rate for Payer: Railroad Medicare Medicare |
$15,227.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,209.68
|
| Rate for Payer: UHC Core |
$19,150.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,227.61
|
| Rate for Payer: UHC Exchange |
$20,511.15
|
| Rate for Payer: UHC Medicare Advantage |
$15,684.44
|
| Rate for Payer: VA VA |
$15,227.61
|
|
|
SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$28,393.80
|
|
|
Service Code
|
MS-DRG 623
|
| Min. Negotiated Rate |
$13,203.23 |
| Max. Negotiated Rate |
$28,393.80 |
| Rate for Payer: Aetna Medicare |
$14,454.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,372.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,372.68
|
| Rate for Payer: BCBS MAPPO |
$13,898.14
|
| Rate for Payer: BCBS Trust/PPO |
$25,483.42
|
| Rate for Payer: BCN Medicare Advantage |
$13,898.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,898.14
|
| Rate for Payer: Mclaren Medicare |
$13,898.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,593.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,982.86
|
| Rate for Payer: PACE Medicare |
$13,203.23
|
| Rate for Payer: PACE SWMI |
$13,898.14
|
| Rate for Payer: PHP Medicare Advantage |
$13,898.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,710.94
|
| Rate for Payer: Priority Health Medicare |
$13,898.14
|
| Rate for Payer: Priority Health Narrow Network |
$21,368.75
|
| Rate for Payer: Railroad Medicare Medicare |
$13,898.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,393.80
|
| Rate for Payer: UHC Core |
$17,422.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,898.14
|
| Rate for Payer: UHC Exchange |
$18,660.54
|
| Rate for Payer: UHC Medicare Advantage |
$14,315.08
|
| Rate for Payer: VA VA |
$13,898.14
|
|
|
SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$58,355.70
|
|
|
Service Code
|
MS-DRG 622
|
| Min. Negotiated Rate |
$26,641.71 |
| Max. Negotiated Rate |
$58,355.70 |
| Rate for Payer: Aetna Medicare |
$29,165.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,054.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,054.89
|
| Rate for Payer: BCBS MAPPO |
$28,043.91
|
| Rate for Payer: BCBS Trust/PPO |
$40,378.21
|
| Rate for Payer: BCN Medicare Advantage |
$28,043.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,043.91
|
| Rate for Payer: Mclaren Medicare |
$28,043.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29,446.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,250.50
|
| Rate for Payer: PACE Medicare |
$26,641.71
|
| Rate for Payer: PACE SWMI |
$28,043.91
|
| Rate for Payer: PHP Medicare Advantage |
$28,043.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54,897.05
|
| Rate for Payer: Priority Health Medicare |
$28,043.91
|
| Rate for Payer: Priority Health Narrow Network |
$43,917.64
|
| Rate for Payer: Railroad Medicare Medicare |
$28,043.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,355.70
|
| Rate for Payer: UHC Core |
$35,807.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28,043.91
|
| Rate for Payer: UHC Exchange |
$38,351.64
|
| Rate for Payer: UHC Medicare Advantage |
$28,885.23
|
| Rate for Payer: VA VA |
$28,043.91
|
|
|
SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$18,346.74
|
|
|
Service Code
|
MS-DRG 624
|
| Min. Negotiated Rate |
$8,093.17 |
| Max. Negotiated Rate |
$18,346.74 |
| Rate for Payer: Aetna Medicare |
$8,859.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,648.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,648.91
|
| Rate for Payer: BCBS MAPPO |
$8,519.13
|
| Rate for Payer: BCBS Trust/PPO |
$18,346.74
|
| Rate for Payer: BCN Medicare Advantage |
$8,519.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,519.13
|
| Rate for Payer: Mclaren Medicare |
$8,519.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,945.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,797.00
|
| Rate for Payer: PACE Medicare |
$8,093.17
|
| Rate for Payer: PACE SWMI |
$8,519.13
|
| Rate for Payer: PHP Medicare Advantage |
$8,519.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,992.99
|
| Rate for Payer: Priority Health Medicare |
$8,519.13
|
| Rate for Payer: Priority Health Narrow Network |
$12,794.39
|
| Rate for Payer: Railroad Medicare Medicare |
$8,519.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,000.58
|
| Rate for Payer: UHC Core |
$10,431.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,519.13
|
| Rate for Payer: UHC Exchange |
$11,172.86
|
| Rate for Payer: UHC Medicare Advantage |
$8,774.70
|
| Rate for Payer: VA VA |
$8,519.13
|
|
|
SKIN GRAFTS FOR INJURIES WITH CC/MCC
|
Facility
|
IP
|
$55,448.67
|
|
|
Service Code
|
MS-DRG 904
|
| Min. Negotiated Rate |
$22,746.04 |
| Max. Negotiated Rate |
$55,448.67 |
| Rate for Payer: Aetna Medicare |
$24,900.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,929.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,929.00
|
| Rate for Payer: BCBS MAPPO |
$23,943.20
|
| Rate for Payer: BCBS Trust/PPO |
$55,448.67
|
| Rate for Payer: BCN Medicare Advantage |
$23,943.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,943.20
|
| Rate for Payer: Mclaren Medicare |
$23,943.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25,140.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,534.68
|
| Rate for Payer: PACE Medicare |
$22,746.04
|
| Rate for Payer: PACE SWMI |
$23,943.20
|
| Rate for Payer: PHP Medicare Advantage |
$23,943.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46,726.21
|
| Rate for Payer: Priority Health Medicare |
$23,943.20
|
| Rate for Payer: Priority Health Narrow Network |
$37,380.97
|
| Rate for Payer: Railroad Medicare Medicare |
$23,943.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,670.07
|
| Rate for Payer: UHC Core |
$30,478.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,943.20
|
| Rate for Payer: UHC Exchange |
$32,643.41
|
| Rate for Payer: UHC Medicare Advantage |
$24,661.50
|
| Rate for Payer: VA VA |
$23,943.20
|
|
|
SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,763.16
|
|
|
Service Code
|
MS-DRG 905
|
| Min. Negotiated Rate |
$11,303.30 |
| Max. Negotiated Rate |
$24,763.16 |
| Rate for Payer: Aetna Medicare |
$12,374.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,872.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,872.76
|
| Rate for Payer: BCBS MAPPO |
$11,898.21
|
| Rate for Payer: BCBS Trust/PPO |
$24,763.16
|
| Rate for Payer: BCN Medicare Advantage |
$11,898.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,898.21
|
| Rate for Payer: Mclaren Medicare |
$11,898.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,493.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,682.94
|
| Rate for Payer: PACE Medicare |
$11,303.30
|
| Rate for Payer: PACE SWMI |
$11,898.21
|
| Rate for Payer: PHP Medicare Advantage |
$11,898.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,725.97
|
| Rate for Payer: Priority Health Medicare |
$11,898.21
|
| Rate for Payer: Priority Health Narrow Network |
$18,180.78
|
| Rate for Payer: Railroad Medicare Medicare |
$11,898.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,157.76
|
| Rate for Payer: UHC Core |
$14,823.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,898.21
|
| Rate for Payer: UHC Exchange |
$15,876.59
|
| Rate for Payer: UHC Medicare Advantage |
$12,255.16
|
| Rate for Payer: VA VA |
$11,898.21
|
|
|
SKIN ULCERS WITH CC
|
Facility
|
IP
|
$18,455.81
|
|
|
Service Code
|
MS-DRG 593
|
| Min. Negotiated Rate |
$8,745.87 |
| Max. Negotiated Rate |
$18,455.81 |
| Rate for Payer: Aetna Medicare |
$9,574.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,507.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,507.72
|
| Rate for Payer: BCBS MAPPO |
$9,206.18
|
| Rate for Payer: BCBS Trust/PPO |
$13,897.85
|
| Rate for Payer: BCN Medicare Advantage |
$9,206.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,206.18
|
| Rate for Payer: Mclaren Medicare |
$9,206.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,666.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,587.11
|
| Rate for Payer: PACE Medicare |
$8,745.87
|
| Rate for Payer: PACE SWMI |
$9,206.18
|
| Rate for Payer: PHP Medicare Advantage |
$9,206.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,361.97
|
| Rate for Payer: Priority Health Medicare |
$9,206.18
|
| Rate for Payer: Priority Health Narrow Network |
$13,889.58
|
| Rate for Payer: Railroad Medicare Medicare |
$9,206.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,455.81
|
| Rate for Payer: UHC Core |
$11,324.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,206.18
|
| Rate for Payer: UHC Exchange |
$12,129.25
|
| Rate for Payer: UHC Medicare Advantage |
$9,482.37
|
| Rate for Payer: VA VA |
$9,206.18
|
|
|
SKIN ULCERS WITH MCC
|
Facility
|
IP
|
$31,882.39
|
|
|
Service Code
|
MS-DRG 592
|
| Min. Negotiated Rate |
$14,767.93 |
| Max. Negotiated Rate |
$31,882.39 |
| Rate for Payer: Aetna Medicare |
$16,167.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,431.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,431.49
|
| Rate for Payer: BCBS MAPPO |
$15,545.19
|
| Rate for Payer: BCBS Trust/PPO |
$23,305.09
|
| Rate for Payer: BCN Medicare Advantage |
$15,545.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,545.19
|
| Rate for Payer: Mclaren Medicare |
$15,545.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,322.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,876.97
|
| Rate for Payer: PACE Medicare |
$14,767.93
|
| Rate for Payer: PACE SWMI |
$15,545.19
|
| Rate for Payer: PHP Medicare Advantage |
$15,545.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29,992.77
|
| Rate for Payer: Priority Health Medicare |
$15,545.19
|
| Rate for Payer: Priority Health Narrow Network |
$23,994.22
|
| Rate for Payer: Railroad Medicare Medicare |
$15,545.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,882.39
|
| Rate for Payer: UHC Core |
$19,563.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,545.19
|
| Rate for Payer: UHC Exchange |
$20,953.25
|
| Rate for Payer: UHC Medicare Advantage |
$16,011.55
|
| Rate for Payer: VA VA |
$15,545.19
|
|
|
SKIN ULCERS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,011.00
|
|
|
Service Code
|
MS-DRG 594
|
| Min. Negotiated Rate |
$5,855.25 |
| Max. Negotiated Rate |
$12,011.00 |
| Rate for Payer: Aetna Medicare |
$6,409.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,704.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,704.28
|
| Rate for Payer: BCBS MAPPO |
$6,163.42
|
| Rate for Payer: BCBS Trust/PPO |
$9,044.91
|
| Rate for Payer: BCN Medicare Advantage |
$6,163.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,163.42
|
| Rate for Payer: Mclaren Medicare |
$6,163.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,471.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,087.93
|
| Rate for Payer: PACE Medicare |
$5,855.25
|
| Rate for Payer: PACE SWMI |
$6,163.42
|
| Rate for Payer: PHP Medicare Advantage |
$6,163.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,299.13
|
| Rate for Payer: Priority Health Medicare |
$6,163.42
|
| Rate for Payer: Priority Health Narrow Network |
$9,039.30
|
| Rate for Payer: Railroad Medicare Medicare |
$6,163.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,011.00
|
| Rate for Payer: UHC Core |
$7,370.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,163.42
|
| Rate for Payer: UHC Exchange |
$7,893.69
|
| Rate for Payer: UHC Medicare Advantage |
$6,348.32
|
| Rate for Payer: VA VA |
$6,163.42
|
|
|
SLING OPERATION FOR CORRECTION OF MALE URINARY INCONTINENCE (EG, FASCIA OR SYNTHETIC)
|
Facility
|
OP
|
$14,277.66
|
|
|
Service Code
|
CPT 53440
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$736.74 |
| Max. Negotiated Rate |
$14,277.66 |
| Rate for Payer: Aetna Medicare |
$11,879.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,277.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,277.66
|
| Rate for Payer: BCBS Complete |
$6,560.87
|
| Rate for Payer: BCBS MAPPO |
$11,422.13
|
| Rate for Payer: BCBS Trust/PPO |
$6,276.50
|
| Rate for Payer: BCN Medicare Advantage |
$11,422.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,422.13
|
| Rate for Payer: Mclaren Medicaid |
$6,247.91
|
| Rate for Payer: Mclaren Medicare |
$11,422.13
|
| Rate for Payer: Meridian Medicaid |
$6,560.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,993.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,135.45
|
| Rate for Payer: PACE Medicare |
$10,851.02
|
| Rate for Payer: PACE SWMI |
$11,422.13
|
| Rate for Payer: PHP Medicare Advantage |
$11,422.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,247.91
|
| Rate for Payer: Priority Health Medicare |
$11,422.13
|
| Rate for Payer: Railroad Medicare Medicare |
$11,422.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.41
|
| Rate for Payer: UHC Core |
$8,819.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,422.13
|
| Rate for Payer: UHC Exchange |
$736.74
|
| Rate for Payer: UHC Medicare Advantage |
$11,764.79
|
| Rate for Payer: VA VA |
$11,422.13
|
|
|
SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC)
|
Facility
|
OP
|
$6,837.00
|
|
|
Service Code
|
CPT 57288
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$734.12 |
| Max. Negotiated Rate |
$6,837.00 |
| Rate for Payer: Aetna Medicare |
$4,602.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,532.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,532.19
|
| Rate for Payer: BCBS Complete |
$2,542.15
|
| Rate for Payer: BCBS MAPPO |
$4,425.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,625.95
|
| Rate for Payer: BCN Medicare Advantage |
$4,425.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,425.75
|
| Rate for Payer: Mclaren Medicaid |
$2,420.89
|
| Rate for Payer: Mclaren Medicare |
$4,425.75
|
| Rate for Payer: Meridian Medicaid |
$2,542.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,647.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,089.61
|
| Rate for Payer: PACE Medicare |
$4,204.46
|
| Rate for Payer: PACE SWMI |
$4,425.75
|
| Rate for Payer: PHP Medicare Advantage |
$4,425.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,420.89
|
| Rate for Payer: Priority Health Medicare |
$4,425.75
|
| Rate for Payer: Railroad Medicare Medicare |
$4,425.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$807.53
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,425.75
|
| Rate for Payer: UHC Exchange |
$734.12
|
| Rate for Payer: UHC Medicare Advantage |
$4,558.52
|
| Rate for Payer: VA VA |
$4,425.75
|
|
|
SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); EXCEPT NEWBORN
|
Facility
|
OP
|
$5,561.92
|
|
|
Service Code
|
CPT 54001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$138.51 |
| Max. Negotiated Rate |
$5,561.92 |
| Rate for Payer: Aetna Medicare |
$1,884.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,265.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,265.42
|
| Rate for Payer: BCBS Complete |
$1,041.01
|
| Rate for Payer: BCBS MAPPO |
$1,812.34
|
| Rate for Payer: BCBS Trust/PPO |
$831.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,812.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,812.34
|
| Rate for Payer: Mclaren Medicaid |
$991.35
|
| Rate for Payer: Mclaren Medicare |
$1,812.34
|
| Rate for Payer: Meridian Medicaid |
$1,041.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,902.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,084.19
|
| Rate for Payer: PACE Medicare |
$1,721.72
|
| Rate for Payer: PACE SWMI |
$1,812.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,812.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,561.92
|
| Rate for Payer: Priority Health Medicare |
$1,812.34
|
| Rate for Payer: Priority Health Narrow Network |
$4,449.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,812.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.36
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,812.34
|
| Rate for Payer: UHC Exchange |
$138.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,866.71
|
| Rate for Payer: VA VA |
$1,812.34
|
|
|
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$5,222.22
|
|
|
Service Code
|
CPT 44360
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$139.16 |
| Max. Negotiated Rate |
$5,222.22 |
| Rate for Payer: Aetna Medicare |
$1,760.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,116.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,116.40
|
| Rate for Payer: BCBS Complete |
$972.53
|
| Rate for Payer: BCBS MAPPO |
$1,693.12
|
| Rate for Payer: BCBS Trust/PPO |
$527.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,693.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,693.12
|
| Rate for Payer: Mclaren Medicaid |
$926.14
|
| Rate for Payer: Mclaren Medicare |
$1,693.12
|
| Rate for Payer: Meridian Medicaid |
$972.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,777.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,947.09
|
| Rate for Payer: PACE Medicare |
$1,608.46
|
| Rate for Payer: PACE SWMI |
$1,693.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,693.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,222.22
|
| Rate for Payer: Priority Health Medicare |
$1,693.12
|
| Rate for Payer: Priority Health Narrow Network |
$4,177.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,693.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.08
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,693.12
|
| Rate for Payer: UHC Exchange |
$139.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,743.91
|
| Rate for Payer: VA VA |
$1,693.12
|
|
|
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$5,222.22
|
|
|
Service Code
|
CPT 44361
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$153.24 |
| Max. Negotiated Rate |
$5,222.22 |
| Rate for Payer: Aetna Medicare |
$1,760.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,116.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,116.40
|
| Rate for Payer: BCBS Complete |
$972.53
|
| Rate for Payer: BCBS MAPPO |
$1,693.12
|
| Rate for Payer: BCBS Trust/PPO |
$527.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,693.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,693.12
|
| Rate for Payer: Mclaren Medicaid |
$926.14
|
| Rate for Payer: Mclaren Medicare |
$1,693.12
|
| Rate for Payer: Meridian Medicaid |
$972.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,777.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,947.09
|
| Rate for Payer: PACE Medicare |
$1,608.46
|
| Rate for Payer: PACE SWMI |
$1,693.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,693.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,222.22
|
| Rate for Payer: Priority Health Medicare |
$1,693.12
|
| Rate for Payer: Priority Health Narrow Network |
$4,177.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,693.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.56
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,693.12
|
| Rate for Payer: UHC Exchange |
$153.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,743.91
|
| Rate for Payer: VA VA |
$1,693.12
|
|
|
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$5,222.22
|
|
|
Service Code
|
CPT 44364
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$197.12 |
| Max. Negotiated Rate |
$5,222.22 |
| Rate for Payer: Aetna Medicare |
$1,760.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,116.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,116.40
|
| Rate for Payer: BCBS Complete |
$972.53
|
| Rate for Payer: BCBS MAPPO |
$1,693.12
|
| Rate for Payer: BCBS Trust/PPO |
$615.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,693.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,693.12
|
| Rate for Payer: Mclaren Medicaid |
$926.14
|
| Rate for Payer: Mclaren Medicare |
$1,693.12
|
| Rate for Payer: Meridian Medicaid |
$972.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,777.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,947.09
|
| Rate for Payer: PACE Medicare |
$1,608.46
|
| Rate for Payer: PACE SWMI |
$1,693.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,693.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,222.22
|
| Rate for Payer: Priority Health Medicare |
$1,693.12
|
| Rate for Payer: Priority Health Narrow Network |
$4,177.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,693.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.83
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,693.12
|
| Rate for Payer: UHC Exchange |
$197.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,743.91
|
| Rate for Payer: VA VA |
$1,693.12
|
|
|
SNF Bill Type
|
Facility
|
IP
|
$893.00
|
|
|
Service Code
|
LOCAL 213
|
| Min. Negotiated Rate |
$893.00 |
| Max. Negotiated Rate |
$893.00 |
| Rate for Payer: UHC Exchange |
$893.00
|
|
|
SNF Bill Type
|
Facility
|
IP
|
$893.00
|
|
|
Service Code
|
LOCAL 216
|
| Min. Negotiated Rate |
$893.00 |
| Max. Negotiated Rate |
$893.00 |
| Rate for Payer: UHC Exchange |
$893.00
|
|
