INPATIENT APRDRG 6081: NEONATE BWT 1250-1499G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$7,756.48
|
|
Service Code
|
APR-DRG 6081
|
Hospital Charge Code |
APRDRG 6081
|
Min. Negotiated Rate |
$7,387.12 |
Max. Negotiated Rate |
$7,756.48 |
Rate for Payer: BCBS Complete |
$7,756.48
|
Rate for Payer: Mclaren Medicaid |
$7,387.12
|
Rate for Payer: Meridian Medicaid |
$7,756.48
|
Rate for Payer: Priority Health Choice Medicaid |
$7,387.12
|
|
INPATIENT APRDRG 6082: NEONATE BWT 1250-1499G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$18,027.92
|
|
Service Code
|
APR-DRG 6082
|
Hospital Charge Code |
APRDRG 6082
|
Min. Negotiated Rate |
$17,169.45 |
Max. Negotiated Rate |
$18,027.92 |
Rate for Payer: BCBS Complete |
$18,027.92
|
Rate for Payer: Mclaren Medicaid |
$17,169.45
|
Rate for Payer: Meridian Medicaid |
$18,027.92
|
Rate for Payer: Priority Health Choice Medicaid |
$17,169.45
|
|
INPATIENT APRDRG 6083: NEONATE BWT 1250-1499G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$24,070.97
|
|
Service Code
|
APR-DRG 6083
|
Hospital Charge Code |
APRDRG 6083
|
Min. Negotiated Rate |
$22,924.73 |
Max. Negotiated Rate |
$24,070.97 |
Rate for Payer: BCBS Complete |
$24,070.97
|
Rate for Payer: Mclaren Medicaid |
$22,924.73
|
Rate for Payer: Meridian Medicaid |
$24,070.97
|
Rate for Payer: Priority Health Choice Medicaid |
$22,924.73
|
|
INPATIENT APRDRG 6084: NEONATE BWT 1250-1499G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$30,230.73
|
|
Service Code
|
APR-DRG 6084
|
Hospital Charge Code |
APRDRG 6084
|
Min. Negotiated Rate |
$28,791.17 |
Max. Negotiated Rate |
$30,230.73 |
Rate for Payer: BCBS Complete |
$30,230.73
|
Rate for Payer: Mclaren Medicaid |
$28,791.17
|
Rate for Payer: Meridian Medicaid |
$30,230.73
|
Rate for Payer: Priority Health Choice Medicaid |
$28,791.17
|
|
INPATIENT APRDRG 6091: NEONATE BWT 1500-2499G W MAJOR PROCEDURE
|
Facility
|
IP
|
$26,859.04
|
|
Service Code
|
APR-DRG 6091
|
Hospital Charge Code |
APRDRG 6091
|
Min. Negotiated Rate |
$25,580.04 |
Max. Negotiated Rate |
$26,859.04 |
Rate for Payer: BCBS Complete |
$26,859.04
|
Rate for Payer: Mclaren Medicaid |
$25,580.04
|
Rate for Payer: Meridian Medicaid |
$26,859.04
|
Rate for Payer: Priority Health Choice Medicaid |
$25,580.04
|
|
INPATIENT APRDRG 6092: NEONATE BWT 1500-2499G W MAJOR PROCEDURE
|
Facility
|
IP
|
$27,413.89
|
|
Service Code
|
APR-DRG 6092
|
Hospital Charge Code |
APRDRG 6092
|
Min. Negotiated Rate |
$26,108.47 |
Max. Negotiated Rate |
$27,413.89 |
Rate for Payer: BCBS Complete |
$27,413.89
|
Rate for Payer: Mclaren Medicaid |
$26,108.47
|
Rate for Payer: Meridian Medicaid |
$27,413.89
|
Rate for Payer: Priority Health Choice Medicaid |
$26,108.47
|
|
INPATIENT APRDRG 6093: NEONATE BWT 1500-2499G W MAJOR PROCEDURE
|
Facility
|
IP
|
$51,049.60
|
|
Service Code
|
APR-DRG 6093
|
Hospital Charge Code |
APRDRG 6093
|
Min. Negotiated Rate |
$48,618.67 |
Max. Negotiated Rate |
$51,049.60 |
Rate for Payer: BCBS Complete |
$51,049.60
|
Rate for Payer: Mclaren Medicaid |
$48,618.67
|
Rate for Payer: Meridian Medicaid |
$51,049.60
|
Rate for Payer: Priority Health Choice Medicaid |
$48,618.67
|
|
INPATIENT APRDRG 6094: NEONATE BWT 1500-2499G W MAJOR PROCEDURE
|
Facility
|
IP
|
$138,651.25
|
|
Service Code
|
APR-DRG 6094
|
Hospital Charge Code |
APRDRG 6094
|
Min. Negotiated Rate |
$132,048.81 |
Max. Negotiated Rate |
$138,651.25 |
Rate for Payer: BCBS Complete |
$138,651.25
|
Rate for Payer: Mclaren Medicaid |
$132,048.81
|
Rate for Payer: Meridian Medicaid |
$138,651.25
|
Rate for Payer: Priority Health Choice Medicaid |
$132,048.81
|
|
INPATIENT APRDRG 6111: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY
|
Facility
|
IP
|
$5,046.03
|
|
Service Code
|
APR-DRG 6111
|
Hospital Charge Code |
APRDRG 6111
|
Min. Negotiated Rate |
$4,805.74 |
Max. Negotiated Rate |
$5,046.03 |
Rate for Payer: BCBS Complete |
$5,046.03
|
Rate for Payer: Mclaren Medicaid |
$4,805.74
|
Rate for Payer: Meridian Medicaid |
$5,046.03
|
Rate for Payer: Priority Health Choice Medicaid |
$4,805.74
|
|
INPATIENT APRDRG 6112: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY
|
Facility
|
IP
|
$14,750.54
|
|
Service Code
|
APR-DRG 6112
|
Hospital Charge Code |
APRDRG 6112
|
Min. Negotiated Rate |
$14,048.13 |
Max. Negotiated Rate |
$14,750.54 |
Rate for Payer: BCBS Complete |
$14,750.54
|
Rate for Payer: Mclaren Medicaid |
$14,048.13
|
Rate for Payer: Meridian Medicaid |
$14,750.54
|
Rate for Payer: Priority Health Choice Medicaid |
$14,048.13
|
|
INPATIENT APRDRG 6113: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY
|
Facility
|
IP
|
$20,284.72
|
|
Service Code
|
APR-DRG 6113
|
Hospital Charge Code |
APRDRG 6113
|
Min. Negotiated Rate |
$19,318.78 |
Max. Negotiated Rate |
$20,284.72 |
Rate for Payer: BCBS Complete |
$20,284.72
|
Rate for Payer: Mclaren Medicaid |
$19,318.78
|
Rate for Payer: Meridian Medicaid |
$20,284.72
|
Rate for Payer: Priority Health Choice Medicaid |
$19,318.78
|
|
INPATIENT APRDRG 6114: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY
|
Facility
|
IP
|
$33,174.62
|
|
Service Code
|
APR-DRG 6114
|
Hospital Charge Code |
APRDRG 6114
|
Min. Negotiated Rate |
$31,594.88 |
Max. Negotiated Rate |
$33,174.62 |
Rate for Payer: BCBS Complete |
$33,174.62
|
Rate for Payer: Mclaren Medicaid |
$31,594.88
|
Rate for Payer: Meridian Medicaid |
$33,174.62
|
Rate for Payer: Priority Health Choice Medicaid |
$31,594.88
|
|
INPATIENT APRDRG 6121: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$11,267.31
|
|
Service Code
|
APR-DRG 6121
|
Hospital Charge Code |
APRDRG 6121
|
Min. Negotiated Rate |
$10,730.77 |
Max. Negotiated Rate |
$11,267.31 |
Rate for Payer: BCBS Complete |
$11,267.31
|
Rate for Payer: Mclaren Medicaid |
$10,730.77
|
Rate for Payer: Meridian Medicaid |
$11,267.31
|
Rate for Payer: Priority Health Choice Medicaid |
$10,730.77
|
|
INPATIENT APRDRG 6122: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$18,485.03
|
|
Service Code
|
APR-DRG 6122
|
Hospital Charge Code |
APRDRG 6122
|
Min. Negotiated Rate |
$17,604.79 |
Max. Negotiated Rate |
$18,485.03 |
Rate for Payer: BCBS Complete |
$18,485.03
|
Rate for Payer: Mclaren Medicaid |
$17,604.79
|
Rate for Payer: Meridian Medicaid |
$18,485.03
|
Rate for Payer: Priority Health Choice Medicaid |
$17,604.79
|
|
INPATIENT APRDRG 6123: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$31,291.56
|
|
Service Code
|
APR-DRG 6123
|
Hospital Charge Code |
APRDRG 6123
|
Min. Negotiated Rate |
$29,801.49 |
Max. Negotiated Rate |
$31,291.56 |
Rate for Payer: BCBS Complete |
$31,291.56
|
Rate for Payer: Mclaren Medicaid |
$29,801.49
|
Rate for Payer: Meridian Medicaid |
$31,291.56
|
Rate for Payer: Priority Health Choice Medicaid |
$29,801.49
|
|
INPATIENT APRDRG 6124: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND
|
Facility
|
IP
|
$49,930.11
|
|
Service Code
|
APR-DRG 6124
|
Hospital Charge Code |
APRDRG 6124
|
Min. Negotiated Rate |
$47,552.49 |
Max. Negotiated Rate |
$49,930.11 |
Rate for Payer: BCBS Complete |
$49,930.11
|
Rate for Payer: Mclaren Medicaid |
$47,552.49
|
Rate for Payer: Meridian Medicaid |
$49,930.11
|
Rate for Payer: Priority Health Choice Medicaid |
$47,552.49
|
|
INPATIENT APRDRG 6131: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$5,565.23
|
|
Service Code
|
APR-DRG 6131
|
Hospital Charge Code |
APRDRG 6131
|
Min. Negotiated Rate |
$5,300.22 |
Max. Negotiated Rate |
$5,565.23 |
Rate for Payer: BCBS Complete |
$5,565.23
|
Rate for Payer: Mclaren Medicaid |
$5,300.22
|
Rate for Payer: Meridian Medicaid |
$5,565.23
|
Rate for Payer: Priority Health Choice Medicaid |
$5,300.22
|
|
INPATIENT APRDRG 6132: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$18,146.94
|
|
Service Code
|
APR-DRG 6132
|
Hospital Charge Code |
APRDRG 6132
|
Min. Negotiated Rate |
$17,282.80 |
Max. Negotiated Rate |
$18,146.94 |
Rate for Payer: BCBS Complete |
$18,146.94
|
Rate for Payer: Mclaren Medicaid |
$17,282.80
|
Rate for Payer: Meridian Medicaid |
$18,146.94
|
Rate for Payer: Priority Health Choice Medicaid |
$17,282.80
|
|
INPATIENT APRDRG 6133: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$31,595.15
|
|
Service Code
|
APR-DRG 6133
|
Hospital Charge Code |
APRDRG 6133
|
Min. Negotiated Rate |
$30,090.62 |
Max. Negotiated Rate |
$31,595.15 |
Rate for Payer: BCBS Complete |
$31,595.15
|
Rate for Payer: Mclaren Medicaid |
$30,090.62
|
Rate for Payer: Meridian Medicaid |
$31,595.15
|
Rate for Payer: Priority Health Choice Medicaid |
$30,090.62
|
|
INPATIENT APRDRG 6134: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION
|
Facility
|
IP
|
$57,417.51
|
|
Service Code
|
APR-DRG 6134
|
Hospital Charge Code |
APRDRG 6134
|
Min. Negotiated Rate |
$54,683.34 |
Max. Negotiated Rate |
$57,417.51 |
Rate for Payer: BCBS Complete |
$57,417.51
|
Rate for Payer: Mclaren Medicaid |
$54,683.34
|
Rate for Payer: Meridian Medicaid |
$57,417.51
|
Rate for Payer: Priority Health Choice Medicaid |
$54,683.34
|
|
INPATIENT APRDRG 6141: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$4,585.47
|
|
Service Code
|
APR-DRG 6141
|
Hospital Charge Code |
APRDRG 6141
|
Min. Negotiated Rate |
$4,367.11 |
Max. Negotiated Rate |
$4,585.47 |
Rate for Payer: BCBS Complete |
$4,585.47
|
Rate for Payer: Mclaren Medicaid |
$4,367.11
|
Rate for Payer: Meridian Medicaid |
$4,585.47
|
Rate for Payer: Priority Health Choice Medicaid |
$4,367.11
|
|
INPATIENT APRDRG 6142: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$11,479.47
|
|
Service Code
|
APR-DRG 6142
|
Hospital Charge Code |
APRDRG 6142
|
Min. Negotiated Rate |
$10,932.83 |
Max. Negotiated Rate |
$11,479.47 |
Rate for Payer: BCBS Complete |
$11,479.47
|
Rate for Payer: Mclaren Medicaid |
$10,932.83
|
Rate for Payer: Meridian Medicaid |
$11,479.47
|
Rate for Payer: Priority Health Choice Medicaid |
$10,932.83
|
|
INPATIENT APRDRG 6143: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$22,774.38
|
|
Service Code
|
APR-DRG 6143
|
Hospital Charge Code |
APRDRG 6143
|
Min. Negotiated Rate |
$21,689.89 |
Max. Negotiated Rate |
$22,774.38 |
Rate for Payer: BCBS Complete |
$22,774.38
|
Rate for Payer: Mclaren Medicaid |
$21,689.89
|
Rate for Payer: Meridian Medicaid |
$22,774.38
|
Rate for Payer: Priority Health Choice Medicaid |
$21,689.89
|
|
INPATIENT APRDRG 6144: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$30,301.45
|
|
Service Code
|
APR-DRG 6144
|
Hospital Charge Code |
APRDRG 6144
|
Min. Negotiated Rate |
$28,858.52 |
Max. Negotiated Rate |
$30,301.45 |
Rate for Payer: BCBS Complete |
$30,301.45
|
Rate for Payer: Mclaren Medicaid |
$28,858.52
|
Rate for Payer: Meridian Medicaid |
$30,301.45
|
Rate for Payer: Priority Health Choice Medicaid |
$28,858.52
|
|
INPATIENT APRDRG 6211: NEONATE BWT 2000-2499G W MAJOR ANOMALY
|
Facility
|
IP
|
$1,359.82
|
|
Service Code
|
APR-DRG 6211
|
Hospital Charge Code |
APRDRG 6211
|
Min. Negotiated Rate |
$1,295.07 |
Max. Negotiated Rate |
$1,359.82 |
Rate for Payer: BCBS Complete |
$1,359.82
|
Rate for Payer: Mclaren Medicaid |
$1,295.07
|
Rate for Payer: Meridian Medicaid |
$1,359.82
|
Rate for Payer: Priority Health Choice Medicaid |
$1,295.07
|
|