|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$1,214.73
|
|
|
Service Code
|
APR-DRG 6331
|
| Min. Negotiated Rate |
$1,156.89 |
| Max. Negotiated Rate |
$1,214.73 |
| Rate for Payer: BCBS Complete |
$1,214.73
|
| Rate for Payer: Mclaren Medicaid |
$1,156.89
|
| Rate for Payer: Meridian Medicaid |
$1,214.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,156.89
|
| Rate for Payer: UHCCP Medicaid |
$1,156.89
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$16,832.75
|
|
|
Service Code
|
APR-DRG 6301
|
| Min. Negotiated Rate |
$16,031.19 |
| Max. Negotiated Rate |
$16,832.75 |
| Rate for Payer: BCBS Complete |
$16,832.75
|
| Rate for Payer: Mclaren Medicaid |
$16,031.19
|
| Rate for Payer: Meridian Medicaid |
$16,832.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,031.19
|
| Rate for Payer: UHCCP Medicaid |
$16,031.19
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$32,682.14
|
|
|
Service Code
|
APR-DRG 6302
|
| Min. Negotiated Rate |
$31,125.85 |
| Max. Negotiated Rate |
$32,682.14 |
| Rate for Payer: BCBS Complete |
$32,682.14
|
| Rate for Payer: Mclaren Medicaid |
$31,125.85
|
| Rate for Payer: Meridian Medicaid |
$32,682.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$31,125.85
|
| Rate for Payer: UHCCP Medicaid |
$31,125.85
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$133,910.02
|
|
|
Service Code
|
APR-DRG 6304
|
| Min. Negotiated Rate |
$127,533.35 |
| Max. Negotiated Rate |
$133,910.02 |
| Rate for Payer: BCBS Complete |
$133,910.02
|
| Rate for Payer: Mclaren Medicaid |
$127,533.35
|
| Rate for Payer: Meridian Medicaid |
$133,910.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$127,533.35
|
| Rate for Payer: UHCCP Medicaid |
$127,533.35
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$74,098.80
|
|
|
Service Code
|
APR-DRG 6303
|
| Min. Negotiated Rate |
$70,570.29 |
| Max. Negotiated Rate |
$74,098.80 |
| Rate for Payer: BCBS Complete |
$74,098.80
|
| Rate for Payer: Mclaren Medicaid |
$70,570.29
|
| Rate for Payer: Meridian Medicaid |
$74,098.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$70,570.29
|
| Rate for Payer: UHCCP Medicaid |
$70,570.29
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$11,915.97
|
|
|
Service Code
|
APR-DRG 6312
|
| Min. Negotiated Rate |
$11,348.54 |
| Max. Negotiated Rate |
$11,915.97 |
| Rate for Payer: BCBS Complete |
$11,915.97
|
| Rate for Payer: Mclaren Medicaid |
$11,348.54
|
| Rate for Payer: Meridian Medicaid |
$11,915.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,348.54
|
| Rate for Payer: UHCCP Medicaid |
$11,348.54
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$181,631.73
|
|
|
Service Code
|
APR-DRG 6314
|
| Min. Negotiated Rate |
$172,982.60 |
| Max. Negotiated Rate |
$181,631.73 |
| Rate for Payer: BCBS Complete |
$181,631.73
|
| Rate for Payer: Mclaren Medicaid |
$172,982.60
|
| Rate for Payer: Meridian Medicaid |
$181,631.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$172,982.60
|
| Rate for Payer: UHCCP Medicaid |
$172,982.60
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$5,032.47
|
|
|
Service Code
|
APR-DRG 6311
|
| Min. Negotiated Rate |
$4,792.83 |
| Max. Negotiated Rate |
$5,032.47 |
| Rate for Payer: BCBS Complete |
$5,032.47
|
| Rate for Payer: Mclaren Medicaid |
$4,792.83
|
| Rate for Payer: Meridian Medicaid |
$5,032.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,792.83
|
| Rate for Payer: UHCCP Medicaid |
$4,792.83
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$45,755.00
|
|
|
Service Code
|
APR-DRG 6313
|
| Min. Negotiated Rate |
$43,576.19 |
| Max. Negotiated Rate |
$45,755.00 |
| Rate for Payer: BCBS Complete |
$45,755.00
|
| Rate for Payer: Mclaren Medicaid |
$43,576.19
|
| Rate for Payer: Meridian Medicaid |
$45,755.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$43,576.19
|
| Rate for Payer: UHCCP Medicaid |
$43,576.19
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$3,239.29
|
|
|
Service Code
|
APR-DRG 6392
|
| Min. Negotiated Rate |
$3,085.04 |
| Max. Negotiated Rate |
$3,239.29 |
| Rate for Payer: BCBS Complete |
$3,239.29
|
| Rate for Payer: Mclaren Medicaid |
$3,085.04
|
| Rate for Payer: Meridian Medicaid |
$3,239.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,085.04
|
| Rate for Payer: UHCCP Medicaid |
$3,085.04
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$16,369.99
|
|
|
Service Code
|
APR-DRG 6394
|
| Min. Negotiated Rate |
$15,590.47 |
| Max. Negotiated Rate |
$16,369.99 |
| Rate for Payer: BCBS Complete |
$16,369.99
|
| Rate for Payer: Mclaren Medicaid |
$15,590.47
|
| Rate for Payer: Meridian Medicaid |
$16,369.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,590.47
|
| Rate for Payer: UHCCP Medicaid |
$15,590.47
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$10,932.61
|
|
|
Service Code
|
APR-DRG 6393
|
| Min. Negotiated Rate |
$10,412.01 |
| Max. Negotiated Rate |
$10,932.61 |
| Rate for Payer: BCBS Complete |
$10,932.61
|
| Rate for Payer: Mclaren Medicaid |
$10,412.01
|
| Rate for Payer: Meridian Medicaid |
$10,932.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,412.01
|
| Rate for Payer: UHCCP Medicaid |
$10,412.01
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$1,908.87
|
|
|
Service Code
|
APR-DRG 6391
|
| Min. Negotiated Rate |
$1,817.97 |
| Max. Negotiated Rate |
$1,908.87 |
| Rate for Payer: BCBS Complete |
$1,908.87
|
| Rate for Payer: Mclaren Medicaid |
$1,817.97
|
| Rate for Payer: Meridian Medicaid |
$1,908.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,817.97
|
| Rate for Payer: UHCCP Medicaid |
$1,817.97
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$16,022.93
|
|
|
Service Code
|
APR-DRG 6344
|
| Min. Negotiated Rate |
$15,259.93 |
| Max. Negotiated Rate |
$16,022.93 |
| Rate for Payer: BCBS Complete |
$16,022.93
|
| Rate for Payer: Mclaren Medicaid |
$15,259.93
|
| Rate for Payer: Meridian Medicaid |
$16,022.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,259.93
|
| Rate for Payer: UHCCP Medicaid |
$15,259.93
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$7,924.70
|
|
|
Service Code
|
APR-DRG 6343
|
| Min. Negotiated Rate |
$7,547.33 |
| Max. Negotiated Rate |
$7,924.70 |
| Rate for Payer: BCBS Complete |
$7,924.70
|
| Rate for Payer: Mclaren Medicaid |
$7,547.33
|
| Rate for Payer: Meridian Medicaid |
$7,924.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,547.33
|
| Rate for Payer: UHCCP Medicaid |
$7,547.33
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$4,280.49
|
|
|
Service Code
|
APR-DRG 6342
|
| Min. Negotiated Rate |
$4,076.66 |
| Max. Negotiated Rate |
$4,280.49 |
| Rate for Payer: BCBS Complete |
$4,280.49
|
| Rate for Payer: Mclaren Medicaid |
$4,076.66
|
| Rate for Payer: Meridian Medicaid |
$4,280.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,076.66
|
| Rate for Payer: UHCCP Medicaid |
$4,076.66
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$3,759.89
|
|
|
Service Code
|
APR-DRG 6341
|
| Min. Negotiated Rate |
$3,580.85 |
| Max. Negotiated Rate |
$3,759.89 |
| Rate for Payer: BCBS Complete |
$3,759.89
|
| Rate for Payer: Mclaren Medicaid |
$3,580.85
|
| Rate for Payer: Meridian Medicaid |
$3,759.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,580.85
|
| Rate for Payer: UHCCP Medicaid |
$3,580.85
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$100,533.74
|
|
|
Service Code
|
APR-DRG 5913
|
| Min. Negotiated Rate |
$95,746.42 |
| Max. Negotiated Rate |
$100,533.74 |
| Rate for Payer: BCBS Complete |
$100,533.74
|
| Rate for Payer: Mclaren Medicaid |
$95,746.42
|
| Rate for Payer: Meridian Medicaid |
$100,533.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$95,746.42
|
| Rate for Payer: UHCCP Medicaid |
$95,746.42
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$128,646.17
|
|
|
Service Code
|
APR-DRG 5914
|
| Min. Negotiated Rate |
$122,520.16 |
| Max. Negotiated Rate |
$128,646.17 |
| Rate for Payer: BCBS Complete |
$128,646.17
|
| Rate for Payer: Mclaren Medicaid |
$122,520.16
|
| Rate for Payer: Meridian Medicaid |
$128,646.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$122,520.16
|
| Rate for Payer: UHCCP Medicaid |
$122,520.16
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$16,832.75
|
|
|
Service Code
|
APR-DRG 5911
|
| Min. Negotiated Rate |
$16,031.19 |
| Max. Negotiated Rate |
$16,832.75 |
| Rate for Payer: BCBS Complete |
$16,832.75
|
| Rate for Payer: Mclaren Medicaid |
$16,031.19
|
| Rate for Payer: Meridian Medicaid |
$16,832.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,031.19
|
| Rate for Payer: UHCCP Medicaid |
$16,031.19
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
|
IP
|
$85,725.55
|
|
|
Service Code
|
APR-DRG 5912
|
| Min. Negotiated Rate |
$81,643.38 |
| Max. Negotiated Rate |
$85,725.55 |
| Rate for Payer: BCBS Complete |
$85,725.55
|
| Rate for Payer: Mclaren Medicaid |
$81,643.38
|
| Rate for Payer: Meridian Medicaid |
$85,725.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$81,643.38
|
| Rate for Payer: UHCCP Medicaid |
$81,643.38
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION
|
Facility
|
IP
|
$101,574.94
|
|
|
Service Code
|
APR-DRG 5893
|
| Min. Negotiated Rate |
$96,738.04 |
| Max. Negotiated Rate |
$101,574.94 |
| Rate for Payer: BCBS Complete |
$101,574.94
|
| Rate for Payer: Mclaren Medicaid |
$96,738.04
|
| Rate for Payer: Meridian Medicaid |
$101,574.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$96,738.04
|
| Rate for Payer: UHCCP Medicaid |
$96,738.04
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION
|
Facility
|
IP
|
$101,574.94
|
|
|
Service Code
|
APR-DRG 5892
|
| Min. Negotiated Rate |
$96,738.04 |
| Max. Negotiated Rate |
$101,574.94 |
| Rate for Payer: BCBS Complete |
$101,574.94
|
| Rate for Payer: Mclaren Medicaid |
$96,738.04
|
| Rate for Payer: Meridian Medicaid |
$101,574.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$96,738.04
|
| Rate for Payer: UHCCP Medicaid |
$96,738.04
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION
|
Facility
|
IP
|
$1,619.65
|
|
|
Service Code
|
APR-DRG 5894
|
| Min. Negotiated Rate |
$1,542.52 |
| Max. Negotiated Rate |
$1,619.65 |
| Rate for Payer: BCBS Complete |
$1,619.65
|
| Rate for Payer: Mclaren Medicaid |
$1,542.52
|
| Rate for Payer: Meridian Medicaid |
$1,619.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,542.52
|
| Rate for Payer: UHCCP Medicaid |
$1,542.52
|
|
|
APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION
|
Facility
|
IP
|
$100,186.67
|
|
|
Service Code
|
APR-DRG 5891
|
| Min. Negotiated Rate |
$95,415.88 |
| Max. Negotiated Rate |
$100,186.67 |
| Rate for Payer: BCBS Complete |
$100,186.67
|
| Rate for Payer: Mclaren Medicaid |
$95,415.88
|
| Rate for Payer: Meridian Medicaid |
$100,186.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$95,415.88
|
| Rate for Payer: UHCCP Medicaid |
$95,415.88
|
|