|
OTHER O.R. PROCEDURES FOR INJURIES WITH CC
|
Facility
|
IP
|
$35,014.75
|
|
|
Service Code
|
MS-DRG 908
|
| Min. Negotiated Rate |
$15,158.21 |
| Max. Negotiated Rate |
$35,014.75 |
| Rate for Payer: Aetna Medicare |
$16,594.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,945.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,945.01
|
| Rate for Payer: BCBS MAPPO |
$15,956.01
|
| Rate for Payer: BCBS Trust/PPO |
$35,014.75
|
| Rate for Payer: BCN Medicare Advantage |
$15,956.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,956.01
|
| Rate for Payer: Mclaren Medicare |
$15,956.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,753.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,349.41
|
| Rate for Payer: PACE Medicare |
$15,158.21
|
| Rate for Payer: PACE SWMI |
$15,956.01
|
| Rate for Payer: PHP Medicare Advantage |
$15,956.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,758.67
|
| Rate for Payer: Priority Health Medicare |
$15,956.01
|
| Rate for Payer: Priority Health Narrow Network |
$23,006.94
|
| Rate for Payer: Railroad Medicare Medicare |
$15,956.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,570.54
|
| Rate for Payer: UHC Core |
$25,067.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,956.01
|
| Rate for Payer: UHC Exchange |
$19,928.77
|
| Rate for Payer: UHC Medicare Advantage |
$16,434.69
|
| Rate for Payer: VA VA |
$15,956.01
|
|
|
OTHER O.R. PROCEDURES FOR INJURIES WITH MCC
|
Facility
|
IP
|
$69,295.73
|
|
|
Service Code
|
MS-DRG 907
|
| Min. Negotiated Rate |
$27,716.20 |
| Max. Negotiated Rate |
$69,295.73 |
| Rate for Payer: Aetna Medicare |
$30,341.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,468.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,468.69
|
| Rate for Payer: BCBS MAPPO |
$29,174.95
|
| Rate for Payer: BCBS Trust/PPO |
$69,295.73
|
| Rate for Payer: BCN Medicare Advantage |
$29,174.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,174.95
|
| Rate for Payer: Mclaren Medicare |
$29,174.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30,633.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,551.19
|
| Rate for Payer: PACE Medicare |
$27,716.20
|
| Rate for Payer: PACE SWMI |
$29,174.95
|
| Rate for Payer: PHP Medicare Advantage |
$29,174.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53,374.53
|
| Rate for Payer: Priority Health Medicare |
$29,174.95
|
| Rate for Payer: Priority Health Narrow Network |
$42,699.62
|
| Rate for Payer: Railroad Medicare Medicare |
$29,174.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,737.25
|
| Rate for Payer: UHC Core |
$46,523.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,174.95
|
| Rate for Payer: UHC Exchange |
$36,986.71
|
| Rate for Payer: UHC Medicare Advantage |
$30,050.20
|
| Rate for Payer: VA VA |
$29,174.95
|
|
|
OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,935.24
|
|
|
Service Code
|
MS-DRG 909
|
| Min. Negotiated Rate |
$10,415.85 |
| Max. Negotiated Rate |
$22,935.24 |
| Rate for Payer: Aetna Medicare |
$11,402.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,705.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,705.06
|
| Rate for Payer: BCBS MAPPO |
$10,964.05
|
| Rate for Payer: BCBS Trust/PPO |
$22,935.24
|
| Rate for Payer: BCN Medicare Advantage |
$10,964.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,964.05
|
| Rate for Payer: Mclaren Medicare |
$10,964.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,512.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,608.66
|
| Rate for Payer: PACE Medicare |
$10,415.85
|
| Rate for Payer: PACE SWMI |
$10,964.05
|
| Rate for Payer: PHP Medicare Advantage |
$10,964.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,462.80
|
| Rate for Payer: Priority Health Medicare |
$10,964.05
|
| Rate for Payer: Priority Health Narrow Network |
$15,570.24
|
| Rate for Payer: Railroad Medicare Medicare |
$10,964.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,689.00
|
| Rate for Payer: UHC Core |
$16,964.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,964.05
|
| Rate for Payer: UHC Exchange |
$13,487.05
|
| Rate for Payer: UHC Medicare Advantage |
$11,292.97
|
| Rate for Payer: VA VA |
$10,964.05
|
|
|
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC
|
Facility
|
IP
|
$76,158.46
|
|
|
Service Code
|
MS-DRG 958
|
| Min. Negotiated Rate |
$30,097.64 |
| Max. Negotiated Rate |
$76,158.46 |
| Rate for Payer: Aetna Medicare |
$32,949.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,602.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,602.16
|
| Rate for Payer: BCBS MAPPO |
$31,681.73
|
| Rate for Payer: BCBS Trust/PPO |
$76,158.46
|
| Rate for Payer: BCN Medicare Advantage |
$31,681.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,681.73
|
| Rate for Payer: Mclaren Medicare |
$31,681.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33,265.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,433.99
|
| Rate for Payer: PACE Medicare |
$30,097.64
|
| Rate for Payer: PACE SWMI |
$31,681.73
|
| Rate for Payer: PHP Medicare Advantage |
$31,681.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58,042.56
|
| Rate for Payer: Priority Health Medicare |
$31,681.73
|
| Rate for Payer: Priority Health Narrow Network |
$46,434.05
|
| Rate for Payer: Railroad Medicare Medicare |
$31,681.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,699.38
|
| Rate for Payer: UHC Core |
$50,592.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,681.73
|
| Rate for Payer: UHC Exchange |
$40,221.49
|
| Rate for Payer: UHC Medicare Advantage |
$32,632.18
|
| Rate for Payer: VA VA |
$31,681.73
|
|
|
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$160,242.61
|
|
|
Service Code
|
MS-DRG 957
|
| Min. Negotiated Rate |
$53,433.93 |
| Max. Negotiated Rate |
$160,242.61 |
| Rate for Payer: Aetna Medicare |
$58,496.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70,307.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70,307.80
|
| Rate for Payer: BCBS MAPPO |
$56,246.24
|
| Rate for Payer: BCBS Trust/PPO |
$160,242.61
|
| Rate for Payer: BCN Medicare Advantage |
$56,246.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56,246.24
|
| Rate for Payer: Mclaren Medicare |
$56,246.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59,058.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64,683.18
|
| Rate for Payer: PACE Medicare |
$53,433.93
|
| Rate for Payer: PACE SWMI |
$56,246.24
|
| Rate for Payer: PHP Medicare Advantage |
$56,246.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103,785.80
|
| Rate for Payer: Priority Health Medicare |
$56,246.24
|
| Rate for Payer: Priority Health Narrow Network |
$83,028.64
|
| Rate for Payer: Railroad Medicare Medicare |
$56,246.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110,324.56
|
| Rate for Payer: UHC Core |
$90,464.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$56,246.24
|
| Rate for Payer: UHC Exchange |
$71,919.98
|
| Rate for Payer: UHC Medicare Advantage |
$57,933.63
|
| Rate for Payer: VA VA |
$56,246.24
|
|
|
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$45,566.42
|
|
|
Service Code
|
MS-DRG 959
|
| Min. Negotiated Rate |
$19,025.75 |
| Max. Negotiated Rate |
$45,566.42 |
| Rate for Payer: Aetna Medicare |
$20,828.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,033.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,033.89
|
| Rate for Payer: BCBS MAPPO |
$20,027.11
|
| Rate for Payer: BCBS Trust/PPO |
$45,566.42
|
| Rate for Payer: BCN Medicare Advantage |
$20,027.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,027.11
|
| Rate for Payer: Mclaren Medicare |
$20,027.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21,028.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,031.18
|
| Rate for Payer: PACE Medicare |
$19,025.75
|
| Rate for Payer: PACE SWMI |
$20,027.11
|
| Rate for Payer: PHP Medicare Advantage |
$20,027.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36,339.74
|
| Rate for Payer: Priority Health Medicare |
$20,027.11
|
| Rate for Payer: Priority Health Narrow Network |
$29,071.79
|
| Rate for Payer: Railroad Medicare Medicare |
$20,027.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38,629.23
|
| Rate for Payer: UHC Core |
$31,675.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,027.11
|
| Rate for Payer: UHC Exchange |
$25,182.19
|
| Rate for Payer: UHC Medicare Advantage |
$20,627.92
|
| Rate for Payer: VA VA |
$20,027.11
|
|
|
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC
|
Facility
|
IP
|
$33,250.69
|
|
|
Service Code
|
MS-DRG 803
|
| Min. Negotiated Rate |
$14,090.12 |
| Max. Negotiated Rate |
$33,250.69 |
| Rate for Payer: Aetna Medicare |
$15,424.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,539.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,539.64
|
| Rate for Payer: BCBS MAPPO |
$14,831.71
|
| Rate for Payer: BCBS Trust/PPO |
$33,250.69
|
| Rate for Payer: BCN Medicare Advantage |
$14,831.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,831.71
|
| Rate for Payer: Mclaren Medicare |
$14,831.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,573.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,056.47
|
| Rate for Payer: PACE Medicare |
$14,090.12
|
| Rate for Payer: PACE SWMI |
$14,831.71
|
| Rate for Payer: PHP Medicare Advantage |
$14,831.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,665.02
|
| Rate for Payer: Priority Health Medicare |
$14,831.71
|
| Rate for Payer: Priority Health Narrow Network |
$21,332.02
|
| Rate for Payer: Railroad Medicare Medicare |
$14,831.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,344.98
|
| Rate for Payer: UHC Core |
$23,242.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,831.71
|
| Rate for Payer: UHC Exchange |
$18,477.94
|
| Rate for Payer: UHC Medicare Advantage |
$15,276.66
|
| Rate for Payer: VA VA |
$14,831.71
|
|
|
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC
|
Facility
|
IP
|
$61,148.91
|
|
|
Service Code
|
MS-DRG 802
|
| Min. Negotiated Rate |
$25,602.71 |
| Max. Negotiated Rate |
$61,148.91 |
| Rate for Payer: Aetna Medicare |
$28,028.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,687.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,687.78
|
| Rate for Payer: BCBS MAPPO |
$26,950.22
|
| Rate for Payer: BCBS Trust/PPO |
$61,148.91
|
| Rate for Payer: BCN Medicare Advantage |
$26,950.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,950.22
|
| Rate for Payer: Mclaren Medicare |
$26,950.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28,297.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,992.75
|
| Rate for Payer: PACE Medicare |
$25,602.71
|
| Rate for Payer: PACE SWMI |
$26,950.22
|
| Rate for Payer: PHP Medicare Advantage |
$26,950.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48,650.53
|
| Rate for Payer: Priority Health Medicare |
$26,950.22
|
| Rate for Payer: Priority Health Narrow Network |
$38,920.42
|
| Rate for Payer: Railroad Medicare Medicare |
$26,950.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51,715.64
|
| Rate for Payer: UHC Core |
$42,405.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,950.22
|
| Rate for Payer: UHC Exchange |
$33,713.14
|
| Rate for Payer: UHC Medicare Advantage |
$27,758.73
|
| Rate for Payer: VA VA |
$26,950.22
|
|
|
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC
|
Facility
|
IP
|
$31,853.52
|
|
|
Service Code
|
MS-DRG 804
|
| Min. Negotiated Rate |
$9,347.74 |
| Max. Negotiated Rate |
$31,853.52 |
| Rate for Payer: Aetna Medicare |
$10,233.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,299.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,299.66
|
| Rate for Payer: BCBS MAPPO |
$9,839.73
|
| Rate for Payer: BCBS Trust/PPO |
$31,853.52
|
| Rate for Payer: BCN Medicare Advantage |
$9,839.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,839.73
|
| Rate for Payer: Mclaren Medicare |
$9,839.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,331.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,315.69
|
| Rate for Payer: PACE Medicare |
$9,347.74
|
| Rate for Payer: PACE SWMI |
$9,839.73
|
| Rate for Payer: PHP Medicare Advantage |
$9,839.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,369.14
|
| Rate for Payer: Priority Health Medicare |
$9,839.73
|
| Rate for Payer: Priority Health Narrow Network |
$13,895.31
|
| Rate for Payer: Railroad Medicare Medicare |
$9,839.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,463.44
|
| Rate for Payer: UHC Core |
$15,139.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,839.73
|
| Rate for Payer: UHC Exchange |
$12,036.22
|
| Rate for Payer: UHC Medicare Advantage |
$10,134.92
|
| Rate for Payer: VA VA |
$9,839.73
|
|
|
OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$33,527.11
|
|
|
Service Code
|
MS-DRG 205
|
| Min. Negotiated Rate |
$13,739.44 |
| Max. Negotiated Rate |
$33,527.11 |
| Rate for Payer: Aetna Medicare |
$15,041.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,078.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,078.21
|
| Rate for Payer: BCBS MAPPO |
$14,462.57
|
| Rate for Payer: BCBS Trust/PPO |
$33,527.11
|
| Rate for Payer: BCN Medicare Advantage |
$14,462.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,462.57
|
| Rate for Payer: Mclaren Medicare |
$14,462.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,185.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,631.96
|
| Rate for Payer: PACE Medicare |
$13,739.44
|
| Rate for Payer: PACE SWMI |
$14,462.57
|
| Rate for Payer: PHP Medicare Advantage |
$14,462.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,977.66
|
| Rate for Payer: Priority Health Medicare |
$14,462.57
|
| Rate for Payer: Priority Health Narrow Network |
$20,782.13
|
| Rate for Payer: Railroad Medicare Medicare |
$14,462.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,614.32
|
| Rate for Payer: UHC Core |
$22,643.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,462.57
|
| Rate for Payer: UHC Exchange |
$18,001.62
|
| Rate for Payer: UHC Medicare Advantage |
$14,896.45
|
| Rate for Payer: VA VA |
$14,462.57
|
|
|
OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC
|
Facility
|
IP
|
$16,080.05
|
|
|
Service Code
|
MS-DRG 206
|
| Min. Negotiated Rate |
$7,174.23 |
| Max. Negotiated Rate |
$16,080.05 |
| Rate for Payer: Aetna Medicare |
$7,853.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,439.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,439.78
|
| Rate for Payer: BCBS MAPPO |
$7,551.82
|
| Rate for Payer: BCBS Trust/PPO |
$16,080.05
|
| Rate for Payer: BCN Medicare Advantage |
$7,551.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,551.82
|
| Rate for Payer: Mclaren Medicare |
$7,551.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,929.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,684.59
|
| Rate for Payer: PACE Medicare |
$7,174.23
|
| Rate for Payer: PACE SWMI |
$7,551.82
|
| Rate for Payer: PHP Medicare Advantage |
$7,551.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,108.65
|
| Rate for Payer: Priority Health Medicare |
$7,551.82
|
| Rate for Payer: Priority Health Narrow Network |
$10,486.92
|
| Rate for Payer: Railroad Medicare Medicare |
$7,551.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,934.53
|
| Rate for Payer: UHC Core |
$11,426.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,551.82
|
| Rate for Payer: UHC Exchange |
$9,083.84
|
| Rate for Payer: UHC Medicare Advantage |
$7,778.37
|
| Rate for Payer: VA VA |
$7,551.82
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$36,401.87
|
|
|
Service Code
|
MS-DRG 167
|
| Min. Negotiated Rate |
$13,809.00 |
| Max. Negotiated Rate |
$36,401.87 |
| Rate for Payer: Aetna Medicare |
$15,117.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,169.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,169.74
|
| Rate for Payer: BCBS MAPPO |
$14,535.79
|
| Rate for Payer: BCBS Trust/PPO |
$36,401.87
|
| Rate for Payer: BCN Medicare Advantage |
$14,535.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,535.79
|
| Rate for Payer: Mclaren Medicare |
$14,535.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,262.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,716.16
|
| Rate for Payer: PACE Medicare |
$13,809.00
|
| Rate for Payer: PACE SWMI |
$14,535.79
|
| Rate for Payer: PHP Medicare Advantage |
$14,535.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,113.98
|
| Rate for Payer: Priority Health Medicare |
$14,535.79
|
| Rate for Payer: Priority Health Narrow Network |
$20,891.18
|
| Rate for Payer: Railroad Medicare Medicare |
$14,535.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,759.23
|
| Rate for Payer: UHC Core |
$22,762.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,535.79
|
| Rate for Payer: UHC Exchange |
$18,096.09
|
| Rate for Payer: UHC Medicare Advantage |
$14,971.86
|
| Rate for Payer: VA VA |
$14,535.79
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$68,340.83
|
|
|
Service Code
|
MS-DRG 166
|
| Min. Negotiated Rate |
$30,192.80 |
| Max. Negotiated Rate |
$68,340.83 |
| Rate for Payer: Aetna Medicare |
$33,053.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,727.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,727.38
|
| Rate for Payer: BCBS MAPPO |
$31,781.90
|
| Rate for Payer: BCBS Trust/PPO |
$68,340.83
|
| Rate for Payer: BCN Medicare Advantage |
$31,781.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,781.90
|
| Rate for Payer: Mclaren Medicare |
$31,781.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33,371.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,549.18
|
| Rate for Payer: PACE Medicare |
$30,192.80
|
| Rate for Payer: PACE SWMI |
$31,781.90
|
| Rate for Payer: PHP Medicare Advantage |
$31,781.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58,229.11
|
| Rate for Payer: Priority Health Medicare |
$31,781.90
|
| Rate for Payer: Priority Health Narrow Network |
$46,583.29
|
| Rate for Payer: Railroad Medicare Medicare |
$31,781.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,897.68
|
| Rate for Payer: UHC Core |
$50,754.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,781.90
|
| Rate for Payer: UHC Exchange |
$40,350.76
|
| Rate for Payer: UHC Medicare Advantage |
$32,735.36
|
| Rate for Payer: VA VA |
$31,781.90
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$30,174.90
|
|
|
Service Code
|
MS-DRG 168
|
| Min. Negotiated Rate |
$10,411.45 |
| Max. Negotiated Rate |
$30,174.90 |
| Rate for Payer: Aetna Medicare |
$11,397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,699.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,699.28
|
| Rate for Payer: BCBS MAPPO |
$10,959.42
|
| Rate for Payer: BCBS Trust/PPO |
$30,174.90
|
| Rate for Payer: BCN Medicare Advantage |
$10,959.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,959.42
|
| Rate for Payer: Mclaren Medicare |
$10,959.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,507.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,603.33
|
| Rate for Payer: PACE Medicare |
$10,411.45
|
| Rate for Payer: PACE SWMI |
$10,959.42
|
| Rate for Payer: PHP Medicare Advantage |
$10,959.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,454.19
|
| Rate for Payer: Priority Health Medicare |
$10,959.42
|
| Rate for Payer: Priority Health Narrow Network |
$15,563.35
|
| Rate for Payer: Railroad Medicare Medicare |
$10,959.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,679.85
|
| Rate for Payer: UHC Core |
$16,957.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,959.42
|
| Rate for Payer: UHC Exchange |
$13,481.08
|
| Rate for Payer: UHC Medicare Advantage |
$11,288.20
|
| Rate for Payer: VA VA |
$10,959.42
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
|
Facility
|
IP
|
$42,636.37
|
|
|
Service Code
|
MS-DRG 580
|
| Min. Negotiated Rate |
$13,273.12 |
| Max. Negotiated Rate |
$42,636.37 |
| Rate for Payer: Aetna Medicare |
$14,530.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,464.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,464.64
|
| Rate for Payer: BCBS MAPPO |
$13,971.71
|
| Rate for Payer: BCBS Trust/PPO |
$42,636.37
|
| Rate for Payer: BCN Medicare Advantage |
$13,971.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,971.71
|
| Rate for Payer: Mclaren Medicare |
$13,971.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,670.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,067.47
|
| Rate for Payer: PACE Medicare |
$13,273.12
|
| Rate for Payer: PACE SWMI |
$13,971.71
|
| Rate for Payer: PHP Medicare Advantage |
$13,971.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,063.57
|
| Rate for Payer: Priority Health Medicare |
$13,971.71
|
| Rate for Payer: Priority Health Narrow Network |
$20,050.86
|
| Rate for Payer: Railroad Medicare Medicare |
$13,971.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,642.64
|
| Rate for Payer: UHC Core |
$21,846.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,971.71
|
| Rate for Payer: UHC Exchange |
$17,368.19
|
| Rate for Payer: UHC Medicare Advantage |
$14,390.86
|
| Rate for Payer: VA VA |
$13,971.71
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC
|
Facility
|
IP
|
$50,981.92
|
|
|
Service Code
|
MS-DRG 579
|
| Min. Negotiated Rate |
$24,954.10 |
| Max. Negotiated Rate |
$50,981.92 |
| Rate for Payer: Aetna Medicare |
$27,318.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,834.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,834.34
|
| Rate for Payer: BCBS MAPPO |
$26,267.47
|
| Rate for Payer: BCBS Trust/PPO |
$46,596.70
|
| Rate for Payer: BCN Medicare Advantage |
$26,267.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,267.47
|
| Rate for Payer: Mclaren Medicare |
$26,267.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27,580.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,207.59
|
| Rate for Payer: PACE Medicare |
$24,954.10
|
| Rate for Payer: PACE SWMI |
$26,267.47
|
| Rate for Payer: PHP Medicare Advantage |
$26,267.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47,960.30
|
| Rate for Payer: Priority Health Medicare |
$26,267.47
|
| Rate for Payer: Priority Health Narrow Network |
$38,368.24
|
| Rate for Payer: Railroad Medicare Medicare |
$26,267.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50,981.92
|
| Rate for Payer: UHC Core |
$41,804.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,267.47
|
| Rate for Payer: UHC Exchange |
$33,234.84
|
| Rate for Payer: UHC Medicare Advantage |
$27,055.49
|
| Rate for Payer: VA VA |
$26,267.47
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$41,183.92
|
|
|
Service Code
|
MS-DRG 581
|
| Min. Negotiated Rate |
$10,345.56 |
| Max. Negotiated Rate |
$41,183.92 |
| Rate for Payer: Aetna Medicare |
$11,325.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,612.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,612.58
|
| Rate for Payer: BCBS MAPPO |
$10,890.06
|
| Rate for Payer: BCBS Trust/PPO |
$41,183.92
|
| Rate for Payer: BCN Medicare Advantage |
$10,890.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,890.06
|
| Rate for Payer: Mclaren Medicare |
$10,890.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,434.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,523.57
|
| Rate for Payer: PACE Medicare |
$10,345.56
|
| Rate for Payer: PACE SWMI |
$10,890.06
|
| Rate for Payer: PHP Medicare Advantage |
$10,890.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,325.04
|
| Rate for Payer: Priority Health Medicare |
$10,890.06
|
| Rate for Payer: Priority Health Narrow Network |
$15,460.03
|
| Rate for Payer: Railroad Medicare Medicare |
$10,890.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,542.56
|
| Rate for Payer: UHC Core |
$16,844.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,890.06
|
| Rate for Payer: UHC Exchange |
$13,391.58
|
| Rate for Payer: UHC Medicare Advantage |
$11,216.76
|
| Rate for Payer: VA VA |
$10,890.06
|
|
|
OTHER VASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$53,577.54
|
|
|
Service Code
|
MS-DRG 253
|
| Min. Negotiated Rate |
$19,162.66 |
| Max. Negotiated Rate |
$53,577.54 |
| Rate for Payer: Aetna Medicare |
$20,978.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,214.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,214.02
|
| Rate for Payer: BCBS MAPPO |
$20,171.22
|
| Rate for Payer: BCBS Trust/PPO |
$53,577.54
|
| Rate for Payer: BCN Medicare Advantage |
$20,171.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,171.22
|
| Rate for Payer: Mclaren Medicare |
$20,171.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21,179.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,196.90
|
| Rate for Payer: PACE Medicare |
$19,162.66
|
| Rate for Payer: PACE SWMI |
$20,171.22
|
| Rate for Payer: PHP Medicare Advantage |
$20,171.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36,608.08
|
| Rate for Payer: Priority Health Medicare |
$20,171.22
|
| Rate for Payer: Priority Health Narrow Network |
$29,286.46
|
| Rate for Payer: Railroad Medicare Medicare |
$20,171.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38,914.48
|
| Rate for Payer: UHC Core |
$31,909.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,171.22
|
| Rate for Payer: UHC Exchange |
$25,368.14
|
| Rate for Payer: UHC Medicare Advantage |
$20,776.36
|
| Rate for Payer: VA VA |
$20,171.22
|
|
|
OTHER VASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$92,959.71
|
|
|
Service Code
|
MS-DRG 252
|
| Min. Negotiated Rate |
$25,039.00 |
| Max. Negotiated Rate |
$92,959.71 |
| Rate for Payer: Aetna Medicare |
$27,411.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,946.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,946.05
|
| Rate for Payer: BCBS MAPPO |
$26,356.84
|
| Rate for Payer: BCBS Trust/PPO |
$92,959.71
|
| Rate for Payer: BCN Medicare Advantage |
$26,356.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,356.84
|
| Rate for Payer: Mclaren Medicare |
$26,356.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27,674.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,310.37
|
| Rate for Payer: PACE Medicare |
$25,039.00
|
| Rate for Payer: PACE SWMI |
$26,356.84
|
| Rate for Payer: PHP Medicare Advantage |
$26,356.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48,126.76
|
| Rate for Payer: Priority Health Medicare |
$26,356.84
|
| Rate for Payer: Priority Health Narrow Network |
$38,501.41
|
| Rate for Payer: Railroad Medicare Medicare |
$26,356.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51,158.87
|
| Rate for Payer: UHC Core |
$41,949.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,356.84
|
| Rate for Payer: UHC Exchange |
$33,350.19
|
| Rate for Payer: UHC Medicare Advantage |
$27,147.55
|
| Rate for Payer: VA VA |
$26,356.84
|
|
|
OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$38,155.87
|
|
|
Service Code
|
MS-DRG 254
|
| Min. Negotiated Rate |
$13,188.93 |
| Max. Negotiated Rate |
$38,155.87 |
| Rate for Payer: Aetna Medicare |
$14,438.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,353.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,353.85
|
| Rate for Payer: BCBS MAPPO |
$13,883.08
|
| Rate for Payer: BCBS Trust/PPO |
$38,155.87
|
| Rate for Payer: BCN Medicare Advantage |
$13,883.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,883.08
|
| Rate for Payer: Mclaren Medicare |
$13,883.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,577.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,965.54
|
| Rate for Payer: PACE Medicare |
$13,188.93
|
| Rate for Payer: PACE SWMI |
$13,883.08
|
| Rate for Payer: PHP Medicare Advantage |
$13,883.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,898.55
|
| Rate for Payer: Priority Health Medicare |
$13,883.08
|
| Rate for Payer: Priority Health Narrow Network |
$19,918.84
|
| Rate for Payer: Railroad Medicare Medicare |
$13,883.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,467.22
|
| Rate for Payer: UHC Core |
$21,702.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,883.08
|
| Rate for Payer: UHC Exchange |
$17,253.83
|
| Rate for Payer: UHC Medicare Advantage |
$14,299.57
|
| Rate for Payer: VA VA |
$13,883.08
|
|
|
OTITIS MEDIA AND URI WITH MCC
|
Facility
|
IP
|
$18,124.80
|
|
|
Service Code
|
MS-DRG 152
|
| Min. Negotiated Rate |
$9,185.22 |
| Max. Negotiated Rate |
$18,124.80 |
| Rate for Payer: Aetna Medicare |
$10,055.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,085.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,085.81
|
| Rate for Payer: BCBS MAPPO |
$9,668.65
|
| Rate for Payer: BCBS Trust/PPO |
$12,976.62
|
| Rate for Payer: BCN Medicare Advantage |
$9,668.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,668.65
|
| Rate for Payer: Mclaren Medicare |
$9,668.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,152.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,118.95
|
| Rate for Payer: PACE Medicare |
$9,185.22
|
| Rate for Payer: PACE SWMI |
$9,668.65
|
| Rate for Payer: PHP Medicare Advantage |
$9,668.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,050.57
|
| Rate for Payer: Priority Health Medicare |
$9,668.65
|
| Rate for Payer: Priority Health Narrow Network |
$13,640.46
|
| Rate for Payer: Railroad Medicare Medicare |
$9,668.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,124.80
|
| Rate for Payer: UHC Core |
$14,862.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,668.65
|
| Rate for Payer: UHC Exchange |
$11,815.46
|
| Rate for Payer: UHC Medicare Advantage |
$9,958.71
|
| Rate for Payer: VA VA |
$9,668.65
|
|
|
OTITIS MEDIA AND URI WITHOUT MCC
|
Facility
|
IP
|
$11,208.64
|
|
|
Service Code
|
MS-DRG 153
|
| Min. Negotiated Rate |
$5,866.00 |
| Max. Negotiated Rate |
$11,208.64 |
| Rate for Payer: Aetna Medicare |
$6,421.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,718.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,718.42
|
| Rate for Payer: BCBS MAPPO |
$6,174.74
|
| Rate for Payer: BCBS Trust/PPO |
$8,981.10
|
| Rate for Payer: BCN Medicare Advantage |
$6,174.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,174.74
|
| Rate for Payer: Mclaren Medicare |
$6,174.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,483.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,100.95
|
| Rate for Payer: PACE Medicare |
$5,866.00
|
| Rate for Payer: PACE SWMI |
$6,174.74
|
| Rate for Payer: PHP Medicare Advantage |
$6,174.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,544.32
|
| Rate for Payer: Priority Health Medicare |
$6,174.74
|
| Rate for Payer: Priority Health Narrow Network |
$8,435.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6,174.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,208.64
|
| Rate for Payer: UHC Core |
$9,190.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,174.74
|
| Rate for Payer: UHC Exchange |
$7,306.85
|
| Rate for Payer: UHC Medicare Advantage |
$6,359.98
|
| Rate for Payer: VA VA |
$6,174.74
|
|
|
OTOLARYNGOLOGIC EXAMINATION UNDER GENERAL ANESTHESIA
|
Facility
|
OP
|
$1,539.60
|
|
|
Service Code
|
CPT 92502
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$93.32 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna Medicare |
$508.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$394.16
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.60
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.68
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.65
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$93.32
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: VA VA |
$489.06
|
|
|
OTOPLASTY, PROTRUDING EAR, WITH OR WITHOUT SIZE REDUCTION
|
Facility
|
OP
|
$9,009.23
|
|
|
Service Code
|
CPT 69300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$465.62 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,629.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.18
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$465.62
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL
|
Facility
|
OP
|
$13,918.15
|
|
|
Service Code
|
CPT 58925
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$758.36 |
| Max. Negotiated Rate |
$13,918.15 |
| Rate for Payer: Aetna Medicare |
$4,598.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,526.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,526.50
|
| Rate for Payer: BCBS Complete |
$2,539.54
|
| Rate for Payer: BCBS MAPPO |
$4,421.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,393.63
|
| Rate for Payer: BCN Medicare Advantage |
$4,421.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,421.20
|
| Rate for Payer: Mclaren Medicaid |
$2,418.40
|
| Rate for Payer: Mclaren Medicare |
$4,421.20
|
| Rate for Payer: Meridian Medicaid |
$2,539.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,642.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,084.38
|
| Rate for Payer: PACE Medicare |
$4,200.14
|
| Rate for Payer: PACE SWMI |
$4,421.20
|
| Rate for Payer: PHP Medicare Advantage |
$4,421.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,418.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,918.15
|
| Rate for Payer: Priority Health Medicare |
$4,421.20
|
| Rate for Payer: Priority Health Narrow Network |
$11,134.52
|
| Rate for Payer: Railroad Medicare Medicare |
$4,421.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$834.20
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,421.20
|
| Rate for Payer: UHC Exchange |
$758.36
|
| Rate for Payer: UHC Medicare Advantage |
$4,553.84
|
| Rate for Payer: VA VA |
$4,421.20
|
|
