|
MAJOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$15,391.29
|
|
|
Service Code
|
MS-DRG 596
|
| Min. Negotiated Rate |
$7,873.34 |
| Max. Negotiated Rate |
$15,391.29 |
| Rate for Payer: Aetna Medicare |
$8,619.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,359.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,359.66
|
| Rate for Payer: BCBS MAPPO |
$8,287.73
|
| Rate for Payer: BCBS Trust/PPO |
$13,896.34
|
| Rate for Payer: BCN Medicare Advantage |
$8,287.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,287.73
|
| Rate for Payer: Mclaren Medicare |
$8,287.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,702.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,530.89
|
| Rate for Payer: PACE Medicare |
$7,873.34
|
| Rate for Payer: PACE SWMI |
$8,287.73
|
| Rate for Payer: PHP Medicare Advantage |
$8,287.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,479.07
|
| Rate for Payer: Priority Health Medicare |
$8,287.73
|
| Rate for Payer: Priority Health Narrow Network |
$11,583.26
|
| Rate for Payer: Railroad Medicare Medicare |
$8,287.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,391.29
|
| Rate for Payer: UHC Core |
$12,620.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,287.73
|
| Rate for Payer: UHC Exchange |
$10,033.50
|
| Rate for Payer: UHC Medicare Advantage |
$8,536.36
|
| Rate for Payer: VA VA |
$8,287.73
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$43,679.23
|
|
|
Service Code
|
MS-DRG 330
|
| Min. Negotiated Rate |
$17,852.24 |
| Max. Negotiated Rate |
$43,679.23 |
| Rate for Payer: Aetna Medicare |
$19,543.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,489.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,489.79
|
| Rate for Payer: BCBS MAPPO |
$18,791.83
|
| Rate for Payer: BCBS Trust/PPO |
$43,679.23
|
| Rate for Payer: BCN Medicare Advantage |
$18,791.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,791.83
|
| Rate for Payer: Mclaren Medicare |
$18,791.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19,731.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,610.60
|
| Rate for Payer: PACE Medicare |
$17,852.24
|
| Rate for Payer: PACE SWMI |
$18,791.83
|
| Rate for Payer: PHP Medicare Advantage |
$18,791.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,039.45
|
| Rate for Payer: Priority Health Medicare |
$18,791.83
|
| Rate for Payer: Priority Health Narrow Network |
$27,231.56
|
| Rate for Payer: Railroad Medicare Medicare |
$18,791.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36,184.01
|
| Rate for Payer: UHC Core |
$29,670.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,791.83
|
| Rate for Payer: UHC Exchange |
$23,588.16
|
| Rate for Payer: UHC Medicare Advantage |
$19,355.58
|
| Rate for Payer: VA VA |
$18,791.83
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$71,987.05
|
|
|
Service Code
|
MS-DRG 329
|
| Min. Negotiated Rate |
$33,553.02 |
| Max. Negotiated Rate |
$71,987.05 |
| Rate for Payer: Aetna Medicare |
$36,731.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44,148.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44,148.71
|
| Rate for Payer: BCBS MAPPO |
$35,318.97
|
| Rate for Payer: BCBS Trust/PPO |
$71,987.05
|
| Rate for Payer: BCN Medicare Advantage |
$35,318.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,318.97
|
| Rate for Payer: Mclaren Medicare |
$35,318.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37,084.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40,616.82
|
| Rate for Payer: PACE Medicare |
$33,553.02
|
| Rate for Payer: PACE SWMI |
$35,318.97
|
| Rate for Payer: PHP Medicare Advantage |
$35,318.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64,815.72
|
| Rate for Payer: Priority Health Medicare |
$35,318.97
|
| Rate for Payer: Priority Health Narrow Network |
$51,852.58
|
| Rate for Payer: Railroad Medicare Medicare |
$35,318.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68,899.27
|
| Rate for Payer: UHC Core |
$56,496.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$35,318.97
|
| Rate for Payer: UHC Exchange |
$44,915.06
|
| Rate for Payer: UHC Medicare Advantage |
$36,378.54
|
| Rate for Payer: VA VA |
$35,318.97
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$32,064.60
|
|
|
Service Code
|
MS-DRG 331
|
| Min. Negotiated Rate |
$12,727.00 |
| Max. Negotiated Rate |
$32,064.60 |
| Rate for Payer: Aetna Medicare |
$13,932.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,746.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,746.05
|
| Rate for Payer: BCBS MAPPO |
$13,396.84
|
| Rate for Payer: BCBS Trust/PPO |
$32,064.60
|
| Rate for Payer: BCN Medicare Advantage |
$13,396.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,396.84
|
| Rate for Payer: Mclaren Medicare |
$13,396.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,066.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,406.37
|
| Rate for Payer: PACE Medicare |
$12,727.00
|
| Rate for Payer: PACE SWMI |
$13,396.84
|
| Rate for Payer: PHP Medicare Advantage |
$13,396.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,993.07
|
| Rate for Payer: Priority Health Medicare |
$13,396.84
|
| Rate for Payer: Priority Health Narrow Network |
$19,194.46
|
| Rate for Payer: Railroad Medicare Medicare |
$13,396.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,504.69
|
| Rate for Payer: UHC Core |
$20,913.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,396.84
|
| Rate for Payer: UHC Exchange |
$16,626.37
|
| Rate for Payer: UHC Medicare Advantage |
$13,798.75
|
| Rate for Payer: VA VA |
$13,396.84
|
|
|
MAJOR THUMB OR JOINT PROCEDURES
|
Facility
|
IP
|
$22,310.50
|
|
|
Service Code
|
MS-DRG 506
|
| Min. Negotiated Rate |
$11,194.04 |
| Max. Negotiated Rate |
$22,310.50 |
| Rate for Payer: Aetna Medicare |
$12,254.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,729.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,729.00
|
| Rate for Payer: BCBS MAPPO |
$11,783.20
|
| Rate for Payer: BCBS Trust/PPO |
$21,844.64
|
| Rate for Payer: BCN Medicare Advantage |
$11,783.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,783.20
|
| Rate for Payer: Mclaren Medicare |
$11,783.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,372.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,550.68
|
| Rate for Payer: PACE Medicare |
$11,194.04
|
| Rate for Payer: PACE SWMI |
$11,783.20
|
| Rate for Payer: PHP Medicare Advantage |
$11,783.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,988.19
|
| Rate for Payer: Priority Health Medicare |
$11,783.20
|
| Rate for Payer: Priority Health Narrow Network |
$16,790.55
|
| Rate for Payer: Railroad Medicare Medicare |
$11,783.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,310.50
|
| Rate for Payer: UHC Core |
$18,294.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,783.20
|
| Rate for Payer: UHC Exchange |
$14,544.09
|
| Rate for Payer: UHC Medicare Advantage |
$12,136.70
|
| Rate for Payer: VA VA |
$11,783.20
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$17,748.61
|
|
|
Service Code
|
MS-DRG 755
|
| Min. Negotiated Rate |
$8,427.53 |
| Max. Negotiated Rate |
$17,748.61 |
| Rate for Payer: Aetna Medicare |
$9,225.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,088.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,088.85
|
| Rate for Payer: BCBS MAPPO |
$8,871.08
|
| Rate for Payer: BCBS Trust/PPO |
$17,748.61
|
| Rate for Payer: BCN Medicare Advantage |
$8,871.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,871.08
|
| Rate for Payer: Mclaren Medicare |
$8,871.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,314.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,201.74
|
| Rate for Payer: PACE Medicare |
$8,427.53
|
| Rate for Payer: PACE SWMI |
$8,871.08
|
| Rate for Payer: PHP Medicare Advantage |
$8,871.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,565.36
|
| Rate for Payer: Priority Health Medicare |
$8,871.08
|
| Rate for Payer: Priority Health Narrow Network |
$12,452.29
|
| Rate for Payer: Railroad Medicare Medicare |
$8,871.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,546.01
|
| Rate for Payer: UHC Core |
$13,567.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,871.08
|
| Rate for Payer: UHC Exchange |
$10,786.26
|
| Rate for Payer: UHC Medicare Advantage |
$9,137.21
|
| Rate for Payer: VA VA |
$8,871.08
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$38,580.55
|
|
|
Service Code
|
MS-DRG 754
|
| Min. Negotiated Rate |
$14,048.39 |
| Max. Negotiated Rate |
$38,580.55 |
| Rate for Payer: Aetna Medicare |
$15,379.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,484.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,484.72
|
| Rate for Payer: BCBS MAPPO |
$14,787.78
|
| Rate for Payer: BCBS Trust/PPO |
$38,580.55
|
| Rate for Payer: BCN Medicare Advantage |
$14,787.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,787.78
|
| Rate for Payer: Mclaren Medicare |
$14,787.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,527.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,005.95
|
| Rate for Payer: PACE Medicare |
$14,048.39
|
| Rate for Payer: PACE SWMI |
$14,787.78
|
| Rate for Payer: PHP Medicare Advantage |
$14,787.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,583.23
|
| Rate for Payer: Priority Health Medicare |
$14,787.78
|
| Rate for Payer: Priority Health Narrow Network |
$21,266.58
|
| Rate for Payer: Railroad Medicare Medicare |
$14,787.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,258.04
|
| Rate for Payer: UHC Core |
$23,171.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,787.78
|
| Rate for Payer: UHC Exchange |
$18,421.26
|
| Rate for Payer: UHC Medicare Advantage |
$15,231.41
|
| Rate for Payer: VA VA |
$14,787.78
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$15,096.88
|
|
|
Service Code
|
MS-DRG 756
|
| Min. Negotiated Rate |
$7,732.06 |
| Max. Negotiated Rate |
$15,096.88 |
| Rate for Payer: Aetna Medicare |
$8,464.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,173.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,173.76
|
| Rate for Payer: BCBS MAPPO |
$8,139.01
|
| Rate for Payer: BCBS Trust/PPO |
$13,431.45
|
| Rate for Payer: BCN Medicare Advantage |
$8,139.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,139.01
|
| Rate for Payer: Mclaren Medicare |
$8,139.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,545.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,359.86
|
| Rate for Payer: PACE Medicare |
$7,732.06
|
| Rate for Payer: PACE SWMI |
$8,139.01
|
| Rate for Payer: PHP Medicare Advantage |
$8,139.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,202.12
|
| Rate for Payer: Priority Health Medicare |
$8,139.01
|
| Rate for Payer: Priority Health Narrow Network |
$11,361.70
|
| Rate for Payer: Railroad Medicare Medicare |
$8,139.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,096.88
|
| Rate for Payer: UHC Core |
$12,379.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,139.01
|
| Rate for Payer: UHC Exchange |
$9,841.58
|
| Rate for Payer: UHC Medicare Advantage |
$8,383.18
|
| Rate for Payer: VA VA |
$8,139.01
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$20,628.40
|
|
|
Service Code
|
MS-DRG 723
|
| Min. Negotiated Rate |
$8,644.22 |
| Max. Negotiated Rate |
$20,628.40 |
| Rate for Payer: Aetna Medicare |
$9,463.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,373.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,373.98
|
| Rate for Payer: BCBS MAPPO |
$9,099.18
|
| Rate for Payer: BCBS Trust/PPO |
$20,628.40
|
| Rate for Payer: BCN Medicare Advantage |
$9,099.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,099.18
|
| Rate for Payer: Mclaren Medicare |
$9,099.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,554.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,464.06
|
| Rate for Payer: PACE Medicare |
$8,644.22
|
| Rate for Payer: PACE SWMI |
$9,099.18
|
| Rate for Payer: PHP Medicare Advantage |
$9,099.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,990.12
|
| Rate for Payer: Priority Health Medicare |
$9,099.18
|
| Rate for Payer: Priority Health Narrow Network |
$12,792.10
|
| Rate for Payer: Railroad Medicare Medicare |
$9,099.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,997.53
|
| Rate for Payer: UHC Core |
$13,937.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,099.18
|
| Rate for Payer: UHC Exchange |
$11,080.60
|
| Rate for Payer: UHC Medicare Advantage |
$9,372.16
|
| Rate for Payer: VA VA |
$9,099.18
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$28,598.20
|
|
|
Service Code
|
MS-DRG 722
|
| Min. Negotiated Rate |
$14,211.66 |
| Max. Negotiated Rate |
$28,598.20 |
| Rate for Payer: Aetna Medicare |
$15,558.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,699.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,699.55
|
| Rate for Payer: BCBS MAPPO |
$14,959.64
|
| Rate for Payer: BCBS Trust/PPO |
$25,747.17
|
| Rate for Payer: BCN Medicare Advantage |
$14,959.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,959.64
|
| Rate for Payer: Mclaren Medicare |
$14,959.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,707.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,203.59
|
| Rate for Payer: PACE Medicare |
$14,211.66
|
| Rate for Payer: PACE SWMI |
$14,959.64
|
| Rate for Payer: PHP Medicare Advantage |
$14,959.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,903.23
|
| Rate for Payer: Priority Health Medicare |
$14,959.64
|
| Rate for Payer: Priority Health Narrow Network |
$21,522.58
|
| Rate for Payer: Railroad Medicare Medicare |
$14,959.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,598.20
|
| Rate for Payer: UHC Core |
$23,450.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,959.64
|
| Rate for Payer: UHC Exchange |
$18,643.01
|
| Rate for Payer: UHC Medicare Advantage |
$15,408.43
|
| Rate for Payer: VA VA |
$14,959.64
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$15,853.89
|
|
|
Service Code
|
MS-DRG 724
|
| Min. Negotiated Rate |
$6,412.88 |
| Max. Negotiated Rate |
$15,853.89 |
| Rate for Payer: Aetna Medicare |
$7,020.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,438.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,438.00
|
| Rate for Payer: BCBS MAPPO |
$6,750.40
|
| Rate for Payer: BCBS Trust/PPO |
$15,853.89
|
| Rate for Payer: BCN Medicare Advantage |
$6,750.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,750.40
|
| Rate for Payer: Mclaren Medicare |
$6,750.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,087.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,762.96
|
| Rate for Payer: PACE Medicare |
$6,412.88
|
| Rate for Payer: PACE SWMI |
$6,750.40
|
| Rate for Payer: PHP Medicare Advantage |
$6,750.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,616.26
|
| Rate for Payer: Priority Health Medicare |
$6,750.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,293.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6,750.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,348.11
|
| Rate for Payer: UHC Core |
$10,125.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,750.40
|
| Rate for Payer: UHC Exchange |
$8,049.67
|
| Rate for Payer: UHC Medicare Advantage |
$6,952.91
|
| Rate for Payer: VA VA |
$6,750.40
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC
|
Facility
|
IP
|
$22,668.87
|
|
|
Service Code
|
MS-DRG 436
|
| Min. Negotiated Rate |
$8,544.68 |
| Max. Negotiated Rate |
$22,668.87 |
| Rate for Payer: Aetna Medicare |
$9,354.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,243.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,243.00
|
| Rate for Payer: BCBS MAPPO |
$8,994.40
|
| Rate for Payer: BCBS Trust/PPO |
$22,668.87
|
| Rate for Payer: BCN Medicare Advantage |
$8,994.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,994.40
|
| Rate for Payer: Mclaren Medicare |
$8,994.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,444.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,343.56
|
| Rate for Payer: PACE Medicare |
$8,544.68
|
| Rate for Payer: PACE SWMI |
$8,994.40
|
| Rate for Payer: PHP Medicare Advantage |
$8,994.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,794.96
|
| Rate for Payer: Priority Health Medicare |
$8,994.40
|
| Rate for Payer: Priority Health Narrow Network |
$12,635.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8,994.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,790.08
|
| Rate for Payer: UHC Core |
$13,767.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,994.40
|
| Rate for Payer: UHC Exchange |
$10,945.36
|
| Rate for Payer: UHC Medicare Advantage |
$9,264.23
|
| Rate for Payer: VA VA |
$8,994.40
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC
|
Facility
|
IP
|
$35,328.86
|
|
|
Service Code
|
MS-DRG 435
|
| Min. Negotiated Rate |
$13,370.49 |
| Max. Negotiated Rate |
$35,328.86 |
| Rate for Payer: Aetna Medicare |
$14,637.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,592.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,592.75
|
| Rate for Payer: BCBS MAPPO |
$14,074.20
|
| Rate for Payer: BCBS Trust/PPO |
$35,328.86
|
| Rate for Payer: BCN Medicare Advantage |
$14,074.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,074.20
|
| Rate for Payer: Mclaren Medicare |
$14,074.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,777.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,185.33
|
| Rate for Payer: PACE Medicare |
$13,370.49
|
| Rate for Payer: PACE SWMI |
$14,074.20
|
| Rate for Payer: PHP Medicare Advantage |
$14,074.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,254.42
|
| Rate for Payer: Priority Health Medicare |
$14,074.20
|
| Rate for Payer: Priority Health Narrow Network |
$20,203.54
|
| Rate for Payer: Railroad Medicare Medicare |
$14,074.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,845.51
|
| Rate for Payer: UHC Core |
$22,012.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,074.20
|
| Rate for Payer: UHC Exchange |
$17,500.45
|
| Rate for Payer: UHC Medicare Advantage |
$14,496.43
|
| Rate for Payer: VA VA |
$14,074.20
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC
|
Facility
|
IP
|
$19,065.37
|
|
|
Service Code
|
MS-DRG 437
|
| Min. Negotiated Rate |
$6,571.00 |
| Max. Negotiated Rate |
$19,065.37 |
| Rate for Payer: Aetna Medicare |
$7,193.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,646.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,646.05
|
| Rate for Payer: BCBS MAPPO |
$6,916.84
|
| Rate for Payer: BCBS Trust/PPO |
$19,065.37
|
| Rate for Payer: BCN Medicare Advantage |
$6,916.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,916.84
|
| Rate for Payer: Mclaren Medicare |
$6,916.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,262.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,954.37
|
| Rate for Payer: PACE Medicare |
$6,571.00
|
| Rate for Payer: PACE SWMI |
$6,916.84
|
| Rate for Payer: PHP Medicare Advantage |
$6,916.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,926.22
|
| Rate for Payer: Priority Health Medicare |
$6,916.84
|
| Rate for Payer: Priority Health Narrow Network |
$9,540.98
|
| Rate for Payer: Railroad Medicare Medicare |
$6,916.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,677.60
|
| Rate for Payer: UHC Core |
$10,395.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,916.84
|
| Rate for Payer: UHC Exchange |
$8,264.46
|
| Rate for Payer: UHC Medicare Advantage |
$7,124.35
|
| Rate for Payer: VA VA |
$6,916.84
|
|
|
MALIGNANT BREAST DISORDERS WITH CC
|
Facility
|
IP
|
$18,286.50
|
|
|
Service Code
|
MS-DRG 598
|
| Min. Negotiated Rate |
$9,262.82 |
| Max. Negotiated Rate |
$18,286.50 |
| Rate for Payer: Aetna Medicare |
$10,140.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,187.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,187.92
|
| Rate for Payer: BCBS MAPPO |
$9,750.34
|
| Rate for Payer: BCBS Trust/PPO |
$18,075.29
|
| Rate for Payer: BCN Medicare Advantage |
$9,750.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,750.34
|
| Rate for Payer: Mclaren Medicare |
$9,750.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,237.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,212.89
|
| Rate for Payer: PACE Medicare |
$9,262.82
|
| Rate for Payer: PACE SWMI |
$9,750.34
|
| Rate for Payer: PHP Medicare Advantage |
$9,750.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,202.68
|
| Rate for Payer: Priority Health Medicare |
$9,750.34
|
| Rate for Payer: Priority Health Narrow Network |
$13,762.14
|
| Rate for Payer: Railroad Medicare Medicare |
$9,750.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,286.50
|
| Rate for Payer: UHC Core |
$14,994.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,750.34
|
| Rate for Payer: UHC Exchange |
$11,920.87
|
| Rate for Payer: UHC Medicare Advantage |
$10,042.85
|
| Rate for Payer: VA VA |
$9,750.34
|
|
|
MALIGNANT BREAST DISORDERS WITH MCC
|
Facility
|
IP
|
$34,203.08
|
|
|
Service Code
|
MS-DRG 597
|
| Min. Negotiated Rate |
$12,203.56 |
| Max. Negotiated Rate |
$34,203.08 |
| Rate for Payer: Aetna Medicare |
$13,359.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,057.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,057.31
|
| Rate for Payer: BCBS MAPPO |
$12,845.85
|
| Rate for Payer: BCBS Trust/PPO |
$34,203.08
|
| Rate for Payer: BCN Medicare Advantage |
$12,845.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,845.85
|
| Rate for Payer: Mclaren Medicare |
$12,845.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,488.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,772.73
|
| Rate for Payer: PACE Medicare |
$12,203.56
|
| Rate for Payer: PACE SWMI |
$12,845.85
|
| Rate for Payer: PHP Medicare Advantage |
$12,845.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,967.05
|
| Rate for Payer: Priority Health Medicare |
$12,845.85
|
| Rate for Payer: Priority Health Narrow Network |
$18,373.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12,845.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,414.03
|
| Rate for Payer: UHC Core |
$20,019.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,845.85
|
| Rate for Payer: UHC Exchange |
$15,915.37
|
| Rate for Payer: UHC Medicare Advantage |
$13,231.23
|
| Rate for Payer: VA VA |
$12,845.85
|
|
|
MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,516.75
|
|
|
Service Code
|
MS-DRG 599
|
| Min. Negotiated Rate |
$5,412.13 |
| Max. Negotiated Rate |
$12,516.75 |
| Rate for Payer: Aetna Medicare |
$5,924.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,121.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,121.22
|
| Rate for Payer: BCBS MAPPO |
$5,696.98
|
| Rate for Payer: BCBS Trust/PPO |
$12,516.75
|
| Rate for Payer: BCN Medicare Advantage |
$5,696.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,696.98
|
| Rate for Payer: Mclaren Medicare |
$5,696.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,981.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,551.53
|
| Rate for Payer: PACE Medicare |
$5,412.13
|
| Rate for Payer: PACE SWMI |
$5,696.98
|
| Rate for Payer: PHP Medicare Advantage |
$5,696.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,917.04
|
| Rate for Payer: Priority Health Medicare |
$5,696.98
|
| Rate for Payer: Priority Health Narrow Network |
$7,133.63
|
| Rate for Payer: Railroad Medicare Medicare |
$5,696.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,478.84
|
| Rate for Payer: UHC Core |
$7,772.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,696.98
|
| Rate for Payer: UHC Exchange |
$6,179.20
|
| Rate for Payer: UHC Medicare Advantage |
$5,867.89
|
| Rate for Payer: VA VA |
$5,696.98
|
|
|
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$39.85
|
|
|
Service Code
|
NDC 0409-4091-11
|
| Hospital Charge Code |
4744
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.53 |
| Max. Negotiated Rate |
$35.86 |
| Rate for Payer: Aetna American Axle |
$25.90
|
| Rate for Payer: Aetna Commercial |
$33.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.90
|
| Rate for Payer: Cash Price |
$31.88
|
| Rate for Payer: Cofinity Commercial |
$27.90
|
| Rate for Payer: Cofinity Commercial |
$34.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.88
|
| Rate for Payer: Healthscope Commercial |
$35.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.87
|
| Rate for Payer: PHP Commercial |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.90
|
| Rate for Payer: Priority Health SBD |
$25.11
|
| Rate for Payer: UMR Bronson Commercial |
$17.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.89
|
|
|
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$39.85
|
|
|
Service Code
|
NDC 0409-4091-01
|
| Hospital Charge Code |
4744
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.53 |
| Max. Negotiated Rate |
$35.86 |
| Rate for Payer: Aetna American Axle |
$25.90
|
| Rate for Payer: Aetna Commercial |
$33.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.90
|
| Rate for Payer: Cash Price |
$31.88
|
| Rate for Payer: Cofinity Commercial |
$27.90
|
| Rate for Payer: Cofinity Commercial |
$34.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.88
|
| Rate for Payer: Healthscope Commercial |
$35.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.87
|
| Rate for Payer: PHP Commercial |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.90
|
| Rate for Payer: Priority Health SBD |
$25.11
|
| Rate for Payer: UMR Bronson Commercial |
$17.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.89
|
|
|
MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESIA (INCLUDES APPLICATION OF TRACTION OR OTHER FIXATION DEVICES)
|
Facility
|
OP
|
$4,497.31
|
|
|
Service Code
|
CPT 27570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$153.90 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.29
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$153.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT, INCLUDING APPLICATION OF FIXATION APPARATUS (DISLOCATION EXCLUDED)
|
Facility
|
OP
|
$4,497.31
|
|
|
Service Code
|
CPT 23700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$195.16 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.68
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$195.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
MANNITOL 20 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$118.65
|
|
|
Service Code
|
NDC 0990-7715-13
|
| Hospital Charge Code |
4749
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$43.90 |
| Max. Negotiated Rate |
$106.78 |
| Rate for Payer: Aetna American Axle |
$77.12
|
| Rate for Payer: Aetna Commercial |
$100.85
|
| 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 Commercial |
$102.04
|
| Rate for Payer: Cofinity Commercial |
$83.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.92
|
| Rate for Payer: Healthscope Commercial |
$106.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$100.85
|
| Rate for Payer: PHP Commercial |
$100.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.06
|
| Rate for Payer: Priority Health SBD |
$74.75
|
| Rate for Payer: UMR Bronson Commercial |
$43.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.99
|
|
|
MANNITOL 20 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$94.92
|
|
|
Service Code
|
NDC 0338-0357-02
|
| Hospital Charge Code |
4749
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$41.76 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Aetna American Axle |
$61.70
|
| Rate for Payer: Aetna Commercial |
$80.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.70
|
| Rate for Payer: Cash Price |
$75.94
|
| Rate for Payer: Cofinity Commercial |
$66.44
|
| Rate for Payer: Cofinity Commercial |
$81.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.94
|
| Rate for Payer: Healthscope Commercial |
$85.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.68
|
| Rate for Payer: PHP Commercial |
$80.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.44
|
| Rate for Payer: Priority Health SBD |
$59.80
|
| Rate for Payer: UMR Bronson Commercial |
$41.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.19
|
|
|
MANNITOL 20 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$118.65
|
|
|
Service Code
|
NDC 0990-7715-03
|
| Hospital Charge Code |
4749
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$43.90 |
| Max. Negotiated Rate |
$106.78 |
| Rate for Payer: Aetna American Axle |
$77.12
|
| Rate for Payer: Aetna Commercial |
$100.85
|
| 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 Commercial |
$102.04
|
| Rate for Payer: Cofinity Commercial |
$83.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.92
|
| Rate for Payer: Healthscope Commercial |
$106.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$100.85
|
| Rate for Payer: PHP Commercial |
$100.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.06
|
| Rate for Payer: Priority Health SBD |
$74.75
|
| Rate for Payer: UMR Bronson Commercial |
$43.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.99
|
|
|
MANNITOL 20 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$94.92
|
|
|
Service Code
|
NDC 0338-0357-02
|
| Hospital Charge Code |
4749
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Aetna American Axle |
$61.70
|
| Rate for Payer: Aetna Commercial |
$80.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.70
|
| Rate for Payer: BCBS Complete |
$37.97
|
| Rate for Payer: Cash Price |
$75.94
|
| Rate for Payer: Cofinity Commercial |
$66.44
|
| Rate for Payer: Cofinity Commercial |
$81.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.94
|
| Rate for Payer: Healthscope Commercial |
$85.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.68
|
| Rate for Payer: PHP Commercial |
$80.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.44
|
| Rate for Payer: Priority Health SBD |
$59.80
|
| Rate for Payer: UMR Bronson Commercial |
$35.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.19
|
|
