|
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$35,656.10
|
|
|
Service Code
|
MSDRG 742
|
| Min. Negotiated Rate |
$15,140.00 |
| Max. Negotiated Rate |
$35,656.10 |
| Rate for Payer: Aetna Medicare |
$16,574.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,921.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,921.05
|
| Rate for Payer: BCBS MAPPO |
$15,936.84
|
| Rate for Payer: BCBS Trust/PPO |
$35,656.10
|
| Rate for Payer: BCN Commercial |
$35,656.10
|
| Rate for Payer: BCN Medicare Advantage |
$15,936.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,936.84
|
| Rate for Payer: Mclaren Medicare |
$15,936.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,733.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,327.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,530.52
|
| Rate for Payer: Nomi Health Commercial |
$23,668.92
|
| Rate for Payer: PACE Medicare |
$15,140.00
|
| Rate for Payer: PACE SWMI |
$15,936.84
|
| Rate for Payer: PHP Medicare Advantage |
$15,936.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29,580.90
|
| Rate for Payer: Priority Health Medicare |
$15,936.84
|
| Rate for Payer: Priority Health Tiered Network |
$23,664.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15,936.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,907.24
|
| Rate for Payer: UHC Core |
$25,021.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,936.84
|
| Rate for Payer: UHC Exchange |
$20,434.17
|
| Rate for Payer: VA VA |
$15,936.84
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$25,836.88
|
|
|
Service Code
|
MSDRG 743
|
| Min. Negotiated Rate |
$10,420.12 |
| Max. Negotiated Rate |
$25,836.88 |
| Rate for Payer: Aetna Medicare |
$11,407.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,710.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,710.69
|
| Rate for Payer: BCBS MAPPO |
$10,968.55
|
| Rate for Payer: BCBS Trust/PPO |
$25,836.88
|
| Rate for Payer: BCN Commercial |
$25,836.88
|
| Rate for Payer: BCN Medicare Advantage |
$10,968.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,968.55
|
| Rate for Payer: Mclaren Medicare |
$10,968.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,516.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,613.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,065.41
|
| Rate for Payer: Nomi Health Commercial |
$16,005.03
|
| Rate for Payer: PACE Medicare |
$10,420.12
|
| Rate for Payer: PACE SWMI |
$10,968.55
|
| Rate for Payer: PHP Medicare Advantage |
$10,968.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,002.74
|
| Rate for Payer: Priority Health Medicare |
$10,968.55
|
| Rate for Payer: Priority Health Tiered Network |
$16,002.19
|
| Rate for Payer: Railroad Medicare Medicare |
$10,968.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,223.41
|
| Rate for Payer: UHC Core |
$16,919.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,968.55
|
| Rate for Payer: UHC Exchange |
$13,817.68
|
| Rate for Payer: VA VA |
$10,968.55
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$43,636.11
|
|
|
Service Code
|
MSDRG 740
|
| Min. Negotiated Rate |
$14,939.81 |
| Max. Negotiated Rate |
$43,636.11 |
| Rate for Payer: Aetna Medicare |
$16,355.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,657.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,657.65
|
| Rate for Payer: BCBS MAPPO |
$15,726.12
|
| Rate for Payer: BCBS Trust/PPO |
$43,636.11
|
| Rate for Payer: BCN Commercial |
$43,636.11
|
| Rate for Payer: BCN Medicare Advantage |
$15,726.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,726.12
|
| Rate for Payer: Mclaren Medicare |
$15,726.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,512.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,085.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,298.73
|
| Rate for Payer: Nomi Health Commercial |
$23,343.84
|
| Rate for Payer: PACE Medicare |
$14,939.81
|
| Rate for Payer: PACE SWMI |
$15,726.12
|
| Rate for Payer: PHP Medicare Advantage |
$15,726.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29,174.62
|
| Rate for Payer: Priority Health Medicare |
$15,726.12
|
| Rate for Payer: Priority Health Tiered Network |
$23,339.70
|
| Rate for Payer: Railroad Medicare Medicare |
$15,726.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,496.48
|
| Rate for Payer: UHC Core |
$24,677.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,726.12
|
| Rate for Payer: UHC Exchange |
$20,153.52
|
| Rate for Payer: VA VA |
$15,726.12
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$69,036.52
|
|
|
Service Code
|
MSDRG 739
|
| Min. Negotiated Rate |
$29,027.09 |
| Max. Negotiated Rate |
$69,036.52 |
| Rate for Payer: Aetna Medicare |
$31,777.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,193.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,193.54
|
| Rate for Payer: BCBS MAPPO |
$30,554.83
|
| Rate for Payer: BCBS Trust/PPO |
$69,036.52
|
| Rate for Payer: BCN Commercial |
$69,036.52
|
| Rate for Payer: BCN Medicare Advantage |
$30,554.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,554.83
|
| Rate for Payer: Mclaren Medicare |
$30,554.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,082.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,138.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$33,610.31
|
| Rate for Payer: Nomi Health Commercial |
$45,489.27
|
| Rate for Payer: PACE Medicare |
$29,027.09
|
| Rate for Payer: PACE SWMI |
$30,554.83
|
| Rate for Payer: PHP Medicare Advantage |
$30,554.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57,762.40
|
| Rate for Payer: Priority Health Medicare |
$30,554.83
|
| Rate for Payer: Priority Health Tiered Network |
$46,209.92
|
| Rate for Payer: Railroad Medicare Medicare |
$30,554.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57,478.69
|
| Rate for Payer: UHC Core |
$48,088.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30,554.83
|
| Rate for Payer: UHC Exchange |
$39,272.40
|
| Rate for Payer: VA VA |
$30,554.83
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$32,521.20
|
|
|
Service Code
|
MSDRG 741
|
| Min. Negotiated Rate |
$11,893.05 |
| Max. Negotiated Rate |
$32,521.20 |
| Rate for Payer: Aetna Medicare |
$13,019.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,648.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,648.75
|
| Rate for Payer: BCBS MAPPO |
$12,519.00
|
| Rate for Payer: BCBS Trust/PPO |
$32,521.20
|
| Rate for Payer: BCN Commercial |
$32,521.20
|
| Rate for Payer: BCN Medicare Advantage |
$12,519.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,519.00
|
| Rate for Payer: Mclaren Medicare |
$12,519.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,144.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,396.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,770.90
|
| Rate for Payer: Nomi Health Commercial |
$18,396.69
|
| Rate for Payer: PACE Medicare |
$11,893.05
|
| Rate for Payer: PACE SWMI |
$12,519.00
|
| Rate for Payer: PHP Medicare Advantage |
$12,519.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22,991.78
|
| Rate for Payer: Priority Health Medicare |
$12,519.00
|
| Rate for Payer: Priority Health Tiered Network |
$18,393.42
|
| Rate for Payer: Railroad Medicare Medicare |
$12,519.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,245.43
|
| Rate for Payer: UHC Core |
$19,447.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,519.00
|
| Rate for Payer: UHC Exchange |
$15,882.48
|
| Rate for Payer: VA VA |
$12,519.00
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$43,449.44
|
|
|
Service Code
|
MSDRG 737
|
| Min. Negotiated Rate |
$16,933.87 |
| Max. Negotiated Rate |
$43,449.44 |
| Rate for Payer: Aetna Medicare |
$18,538.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,281.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,281.41
|
| Rate for Payer: BCBS MAPPO |
$17,825.13
|
| Rate for Payer: BCBS Trust/PPO |
$43,449.44
|
| Rate for Payer: BCN Commercial |
$43,449.44
|
| Rate for Payer: BCN Medicare Advantage |
$17,825.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,825.13
|
| Rate for Payer: Mclaren Medicare |
$17,825.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,716.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,498.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,607.64
|
| Rate for Payer: Nomi Health Commercial |
$26,581.74
|
| Rate for Payer: PACE Medicare |
$16,933.87
|
| Rate for Payer: PACE SWMI |
$17,825.13
|
| Rate for Payer: PHP Medicare Advantage |
$17,825.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33,221.28
|
| Rate for Payer: Priority Health Medicare |
$17,825.13
|
| Rate for Payer: Priority Health Tiered Network |
$26,577.02
|
| Rate for Payer: Railroad Medicare Medicare |
$17,825.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33,587.78
|
| Rate for Payer: UHC Core |
$28,100.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,825.13
|
| Rate for Payer: UHC Exchange |
$22,948.90
|
| Rate for Payer: VA VA |
$17,825.13
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$82,501.24
|
|
|
Service Code
|
MSDRG 736
|
| Min. Negotiated Rate |
$28,961.16 |
| Max. Negotiated Rate |
$82,501.24 |
| Rate for Payer: Aetna Medicare |
$31,704.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,106.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,106.79
|
| Rate for Payer: BCBS MAPPO |
$30,485.43
|
| Rate for Payer: BCBS Trust/PPO |
$82,501.24
|
| Rate for Payer: BCN Commercial |
$82,501.24
|
| Rate for Payer: BCN Medicare Advantage |
$30,485.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,485.43
|
| Rate for Payer: Mclaren Medicare |
$30,485.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,009.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,058.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$33,533.97
|
| Rate for Payer: Nomi Health Commercial |
$46,111.05
|
| Rate for Payer: PACE Medicare |
$28,961.16
|
| Rate for Payer: PACE SWMI |
$30,485.43
|
| Rate for Payer: PHP Medicare Advantage |
$30,485.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57,628.59
|
| Rate for Payer: Priority Health Medicare |
$30,485.43
|
| Rate for Payer: Priority Health Tiered Network |
$46,102.86
|
| Rate for Payer: Railroad Medicare Medicare |
$30,485.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,264.35
|
| Rate for Payer: UHC Core |
$48,745.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30,485.43
|
| Rate for Payer: UHC Exchange |
$39,809.21
|
| Rate for Payer: VA VA |
$30,485.43
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$31,373.75
|
|
|
Service Code
|
MSDRG 738
|
| Min. Negotiated Rate |
$12,229.90 |
| Max. Negotiated Rate |
$31,373.75 |
| Rate for Payer: Aetna Medicare |
$13,388.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,091.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,091.98
|
| Rate for Payer: BCBS MAPPO |
$12,873.58
|
| Rate for Payer: BCBS Trust/PPO |
$31,373.75
|
| Rate for Payer: BCN Commercial |
$31,373.75
|
| Rate for Payer: BCN Medicare Advantage |
$12,873.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,873.58
|
| Rate for Payer: Mclaren Medicare |
$12,873.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,517.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,804.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,160.94
|
| Rate for Payer: Nomi Health Commercial |
$18,943.65
|
| Rate for Payer: PACE Medicare |
$12,229.90
|
| Rate for Payer: PACE SWMI |
$12,873.58
|
| Rate for Payer: PHP Medicare Advantage |
$12,873.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,675.36
|
| Rate for Payer: Priority Health Medicare |
$12,873.58
|
| Rate for Payer: Priority Health Tiered Network |
$18,940.29
|
| Rate for Payer: Railroad Medicare Medicare |
$12,873.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,936.55
|
| Rate for Payer: UHC Core |
$20,025.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,873.58
|
| Rate for Payer: UHC Exchange |
$16,354.68
|
| Rate for Payer: VA VA |
$12,873.58
|
|
|
UVULECTOMY, EXCISION OF UVULA
|
Facility
|
OP
|
$10,683.35
|
|
|
Service Code
|
CPT 42140
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.42
|
| Rate for Payer: BCN Commercial |
$2,064.42
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$32,724.34
|
|
|
Service Code
|
MSDRG 746
|
| Min. Negotiated Rate |
$14,363.82 |
| Max. Negotiated Rate |
$32,724.34 |
| Rate for Payer: Aetna Medicare |
$15,724.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,899.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,899.76
|
| Rate for Payer: BCBS MAPPO |
$15,119.81
|
| Rate for Payer: BCBS Trust/PPO |
$32,724.34
|
| Rate for Payer: BCN Commercial |
$32,724.34
|
| Rate for Payer: BCN Medicare Advantage |
$15,119.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,119.81
|
| Rate for Payer: Mclaren Medicare |
$15,119.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,875.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,387.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,631.79
|
| Rate for Payer: Nomi Health Commercial |
$22,408.59
|
| Rate for Payer: PACE Medicare |
$14,363.82
|
| Rate for Payer: PACE SWMI |
$15,119.81
|
| Rate for Payer: PHP Medicare Advantage |
$15,119.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,005.77
|
| Rate for Payer: Priority Health Medicare |
$15,119.81
|
| Rate for Payer: Priority Health Tiered Network |
$22,404.61
|
| Rate for Payer: Railroad Medicare Medicare |
$15,119.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,314.73
|
| Rate for Payer: UHC Core |
$23,688.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,119.81
|
| Rate for Payer: UHC Exchange |
$19,346.08
|
| Rate for Payer: VA VA |
$15,119.81
|
|
|
VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$27,121.59
|
|
|
Service Code
|
MSDRG 747
|
| Min. Negotiated Rate |
$7,393.25 |
| Max. Negotiated Rate |
$27,121.59 |
| Rate for Payer: Aetna Medicare |
$8,093.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,727.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,727.96
|
| Rate for Payer: BCBS MAPPO |
$7,782.37
|
| Rate for Payer: BCBS Trust/PPO |
$27,121.59
|
| Rate for Payer: BCN Commercial |
$27,121.59
|
| Rate for Payer: BCN Medicare Advantage |
$7,782.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,782.37
|
| Rate for Payer: Mclaren Medicare |
$7,782.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,949.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,560.61
|
| Rate for Payer: Nomi Health Commercial |
$10,829.55
|
| Rate for Payer: PACE Medicare |
$7,393.25
|
| Rate for Payer: PACE SWMI |
$7,782.37
|
| Rate for Payer: PHP Medicare Advantage |
$7,782.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13,860.20
|
| Rate for Payer: Priority Health Medicare |
$7,782.37
|
| Rate for Payer: Priority Health Tiered Network |
$11,088.16
|
| Rate for Payer: Railroad Medicare Medicare |
$7,782.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,683.85
|
| Rate for Payer: UHC Core |
$11,448.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,782.37
|
| Rate for Payer: UHC Exchange |
$9,349.51
|
| Rate for Payer: VA VA |
$7,782.37
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$9,503.00
|
|
|
Service Code
|
APR-DRG 5604
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$9,503.00 |
| Rate for Payer: BCBS Complete |
$9,503.00
|
| Rate for Payer: Mclaren Medicaid |
$9,050.47
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,050.47
|
| Rate for Payer: UHC Medicaid |
$9,050.47
|
| Rate for Payer: UHCCP Medicaid |
$9,050.47
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$2,555.68
|
|
|
Service Code
|
APR-DRG 5601
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$2,555.68 |
| Rate for Payer: BCBS Complete |
$2,555.68
|
| Rate for Payer: Mclaren Medicaid |
$2,433.98
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,433.98
|
| Rate for Payer: UHC Medicaid |
$2,433.98
|
| Rate for Payer: UHCCP Medicaid |
$2,433.98
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$4,180.37
|
|
|
Service Code
|
APR-DRG 5603
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$4,180.37 |
| Rate for Payer: BCBS Complete |
$4,180.37
|
| Rate for Payer: Mclaren Medicaid |
$3,981.31
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,981.31
|
| Rate for Payer: UHC Medicaid |
$3,981.31
|
| Rate for Payer: UHCCP Medicaid |
$3,981.31
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$3,014.52
|
|
|
Service Code
|
APR-DRG 5602
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$3,014.52 |
| Rate for Payer: BCBS Complete |
$3,014.52
|
| Rate for Payer: Mclaren Medicaid |
$2,870.97
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,870.97
|
| Rate for Payer: UHC Medicaid |
$2,870.97
|
| Rate for Payer: UHCCP Medicaid |
$2,870.97
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$3,025.41
|
|
|
Service Code
|
APR-DRG 5421
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$3,025.41 |
| Rate for Payer: BCBS Complete |
$3,025.41
|
| Rate for Payer: Mclaren Medicaid |
$2,881.35
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,881.35
|
| Rate for Payer: UHC Medicaid |
$2,881.35
|
| Rate for Payer: UHCCP Medicaid |
$2,881.35
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$4,928.56
|
|
|
Service Code
|
APR-DRG 5423
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$4,928.56 |
| Rate for Payer: BCBS Complete |
$4,928.56
|
| Rate for Payer: Mclaren Medicaid |
$4,693.86
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.86
|
| Rate for Payer: UHC Medicaid |
$4,693.86
|
| Rate for Payer: UHCCP Medicaid |
$4,693.86
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$13,302.02
|
|
|
Service Code
|
APR-DRG 5424
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$13,302.02 |
| Rate for Payer: BCBS Complete |
$13,302.02
|
| Rate for Payer: Mclaren Medicaid |
$12,668.59
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,668.59
|
| Rate for Payer: UHC Medicaid |
$12,668.59
|
| Rate for Payer: UHCCP Medicaid |
$12,668.59
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$3,711.85
|
|
|
Service Code
|
APR-DRG 5422
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$3,711.85 |
| Rate for Payer: BCBS Complete |
$3,711.85
|
| Rate for Payer: Mclaren Medicaid |
$3,535.10
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,535.10
|
| Rate for Payer: UHC Medicaid |
$3,535.10
|
| Rate for Payer: UHCCP Medicaid |
$3,535.10
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$17,467.08
|
|
|
Service Code
|
MSDRG 768
|
| Min. Negotiated Rate |
$9,076.71 |
| Max. Negotiated Rate |
$17,467.08 |
| Rate for Payer: Aetna Medicare |
$9,936.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,943.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,943.04
|
| Rate for Payer: BCBS MAPPO |
$9,554.43
|
| Rate for Payer: BCBS Trust/PPO |
$12,825.11
|
| Rate for Payer: BCN Commercial |
$12,825.11
|
| Rate for Payer: BCN Medicare Advantage |
$9,554.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,554.43
|
| Rate for Payer: Mclaren Medicare |
$9,554.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,032.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,987.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,509.87
|
| Rate for Payer: Nomi Health Commercial |
$13,823.64
|
| Rate for Payer: PACE Medicare |
$9,076.71
|
| Rate for Payer: PACE SWMI |
$9,554.43
|
| Rate for Payer: PHP Medicare Advantage |
$9,554.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,263.59
|
| Rate for Payer: Priority Health Medicare |
$9,554.43
|
| Rate for Payer: Priority Health Tiered Network |
$13,810.87
|
| Rate for Payer: Railroad Medicare Medicare |
$9,554.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,467.08
|
| Rate for Payer: UHC Core |
$14,613.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,554.43
|
| Rate for Payer: UHC Exchange |
$11,934.41
|
| Rate for Payer: VA VA |
$9,554.43
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC
|
Facility
|
IP
|
$12,290.20
|
|
|
Service Code
|
MSDRG 806
|
| Min. Negotiated Rate |
$5,674.99 |
| Max. Negotiated Rate |
$12,290.20 |
| Rate for Payer: Aetna Medicare |
$7,174.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,623.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,623.05
|
| Rate for Payer: BCBS MAPPO |
$6,898.44
|
| Rate for Payer: BCBS Trust/PPO |
$10,790.99
|
| Rate for Payer: BCN Commercial |
$10,790.99
|
| Rate for Payer: BCN Medicare Advantage |
$6,898.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,898.44
|
| Rate for Payer: Mclaren Medicare |
$6,898.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,243.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,933.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,588.28
|
| Rate for Payer: Nomi Health Commercial |
$9,726.60
|
| Rate for Payer: PACE Medicare |
$6,553.52
|
| Rate for Payer: PACE SWMI |
$6,898.44
|
| Rate for Payer: PHP Medicare Advantage |
$6,898.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7,093.74
|
| Rate for Payer: Priority Health Medicare |
$6,898.44
|
| Rate for Payer: Priority Health Tiered Network |
$5,674.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6,898.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,290.20
|
| Rate for Payer: UHC Core |
$10,282.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,898.44
|
| Rate for Payer: UHC Exchange |
$8,397.30
|
| Rate for Payer: VA VA |
$6,898.44
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC
|
Facility
|
IP
|
$17,590.96
|
|
|
Service Code
|
MSDRG 805
|
| Min. Negotiated Rate |
$8,208.10 |
| Max. Negotiated Rate |
$17,590.96 |
| Rate for Payer: Aetna Medicare |
$10,002.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,022.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,022.49
|
| Rate for Payer: BCBS MAPPO |
$9,617.99
|
| Rate for Payer: BCBS Trust/PPO |
$12,910.21
|
| Rate for Payer: BCN Commercial |
$12,910.21
|
| Rate for Payer: BCN Medicare Advantage |
$9,617.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,617.99
|
| Rate for Payer: Mclaren Medicare |
$9,617.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,098.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,060.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,579.79
|
| Rate for Payer: Nomi Health Commercial |
$13,921.68
|
| Rate for Payer: PACE Medicare |
$9,137.09
|
| Rate for Payer: PACE SWMI |
$9,617.99
|
| Rate for Payer: PHP Medicare Advantage |
$9,617.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,260.13
|
| Rate for Payer: Priority Health Medicare |
$9,617.99
|
| Rate for Payer: Priority Health Tiered Network |
$8,208.10
|
| Rate for Payer: Railroad Medicare Medicare |
$9,617.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,590.96
|
| Rate for Payer: UHC Core |
$14,717.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,617.99
|
| Rate for Payer: UHC Exchange |
$12,019.05
|
| Rate for Payer: VA VA |
$9,617.99
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC
|
Facility
|
IP
|
$10,989.46
|
|
|
Service Code
|
MSDRG 807
|
| Min. Negotiated Rate |
$4,925.64 |
| Max. Negotiated Rate |
$10,989.46 |
| Rate for Payer: Aetna Medicare |
$6,480.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,788.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,788.88
|
| Rate for Payer: BCBS MAPPO |
$6,231.10
|
| Rate for Payer: BCBS Trust/PPO |
$9,588.63
|
| Rate for Payer: BCN Commercial |
$9,588.63
|
| Rate for Payer: BCN Medicare Advantage |
$6,231.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,231.10
|
| Rate for Payer: Mclaren Medicare |
$6,231.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,542.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,165.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,854.21
|
| Rate for Payer: Nomi Health Commercial |
$8,697.18
|
| Rate for Payer: PACE Medicare |
$5,919.55
|
| Rate for Payer: PACE SWMI |
$6,231.10
|
| Rate for Payer: PHP Medicare Advantage |
$6,231.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,157.05
|
| Rate for Payer: Priority Health Medicare |
$6,231.10
|
| Rate for Payer: Priority Health Tiered Network |
$4,925.64
|
| Rate for Payer: Railroad Medicare Medicare |
$6,231.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,989.46
|
| Rate for Payer: UHC Core |
$9,194.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,231.10
|
| Rate for Payer: UHC Exchange |
$7,508.57
|
| Rate for Payer: VA VA |
$6,231.10
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$4,578.68
|
|
|
Service Code
|
APR-DRG 5412
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$4,578.68 |
| Rate for Payer: BCBS Complete |
$4,578.68
|
| Rate for Payer: Mclaren Medicaid |
$4,360.65
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,360.65
|
| Rate for Payer: UHC Medicaid |
$4,360.65
|
| Rate for Payer: UHCCP Medicaid |
$4,360.65
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$6,177.34
|
|
|
Service Code
|
APR-DRG 5414
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$6,177.34 |
| Rate for Payer: BCBS Complete |
$6,177.34
|
| Rate for Payer: Mclaren Medicaid |
$5,883.18
|
| Rate for Payer: Meridian Medicaid |
$2,100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,883.18
|
| Rate for Payer: UHC Medicaid |
$5,883.18
|
| Rate for Payer: UHCCP Medicaid |
$5,883.18
|
|
