|
INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$125,559.80
|
|
|
Service Code
|
HCPCS J1823
|
| Hospital Charge Code |
194137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$259.17 |
| Max. Negotiated Rate |
$113,003.82 |
| Rate for Payer: Aetna American Axle |
$81,613.87
|
| Rate for Payer: Aetna Commercial |
$106,725.83
|
| Rate for Payer: Aetna Medicare |
$515.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81,613.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$619.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$619.44
|
| Rate for Payer: BCBS Complete |
$272.16
|
| Rate for Payer: BCBS MAPPO |
$495.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.86
|
| Rate for Payer: BCN Commercial |
$1,606.86
|
| Rate for Payer: BCN Medicare Advantage |
$495.55
|
| Rate for Payer: Cash Price |
$100,447.84
|
| Rate for Payer: Cash Price |
$100,447.84
|
| Rate for Payer: Cofinity Advantage |
$87,891.86
|
| Rate for Payer: Cofinity Commercial |
$107,981.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100,447.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.55
|
| Rate for Payer: Healthscope Commercial |
$113,003.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87,891.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94,169.85
|
| Rate for Payer: Mclaren Medicaid |
$495.55
|
| Rate for Payer: Mclaren Medicare |
$495.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$520.33
|
| Rate for Payer: Meridian Medicaid |
$520.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$569.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$545.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,725.83
|
| Rate for Payer: Nomi Health Commercial |
$1,486.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94,169.85
|
| Rate for Payer: PACE Medicare |
$470.77
|
| Rate for Payer: PACE SWMI |
$495.55
|
| Rate for Payer: PHP Commercial |
$106,725.83
|
| Rate for Payer: PHP Medicare Advantage |
$495.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,562.93
|
| Rate for Payer: Priority Health Medicare |
$495.55
|
| Rate for Payer: Priority Health SBD |
$79,102.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,250.34
|
| Rate for Payer: Railroad Medicare Medicare |
$495.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$817.66
|
| Rate for Payer: UHC Core |
$817.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$495.55
|
| Rate for Payer: UHC Exchange |
$817.66
|
| Rate for Payer: UHC Medicaid |
$259.17
|
| Rate for Payer: UHCCP Medicaid |
$259.17
|
| Rate for Payer: UMR Bronson Commercial |
$46,457.13
|
| Rate for Payer: VA VA |
$495.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94,169.85
|
|
|
INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$125,559.80
|
|
|
Service Code
|
HCPCS J1823
|
| Hospital Charge Code |
194137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55,246.31 |
| Max. Negotiated Rate |
$113,003.82 |
| Rate for Payer: Aetna American Axle |
$81,613.87
|
| Rate for Payer: Aetna Commercial |
$106,725.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81,613.87
|
| Rate for Payer: Cash Price |
$100,447.84
|
| Rate for Payer: Cofinity Advantage |
$87,891.86
|
| Rate for Payer: Cofinity Commercial |
$107,981.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100,447.84
|
| Rate for Payer: Healthscope Commercial |
$113,003.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87,891.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94,169.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,725.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94,169.85
|
| Rate for Payer: PHP Commercial |
$106,725.83
|
| Rate for Payer: Priority Health SBD |
$79,102.67
|
| Rate for Payer: UMR Bronson Commercial |
$55,246.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94,169.85
|
|
|
INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$15,957.70
|
|
|
Service Code
|
MSDRG 758
|
| Min. Negotiated Rate |
$8,341.05 |
| Max. Negotiated Rate |
$15,957.70 |
| Rate for Payer: Aetna Medicare |
$9,131.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,975.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,975.06
|
| Rate for Payer: BCBS MAPPO |
$8,780.05
|
| Rate for Payer: BCBS Trust/PPO |
$15,608.64
|
| Rate for Payer: BCN Commercial |
$15,608.64
|
| Rate for Payer: BCN Medicare Advantage |
$8,780.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,780.05
|
| Rate for Payer: Mclaren Medicare |
$8,780.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,219.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,097.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,658.06
|
| Rate for Payer: Nomi Health Commercial |
$12,629.10
|
| Rate for Payer: PACE Medicare |
$8,341.05
|
| Rate for Payer: PACE SWMI |
$8,780.05
|
| Rate for Payer: PHP Medicare Advantage |
$8,780.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15,783.58
|
| Rate for Payer: Priority Health Medicare |
$8,780.05
|
| Rate for Payer: Priority Health Tiered Network |
$12,626.86
|
| Rate for Payer: Railroad Medicare Medicare |
$8,780.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,957.70
|
| Rate for Payer: UHC Core |
$13,350.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,780.05
|
| Rate for Payer: UHC Exchange |
$10,903.12
|
| Rate for Payer: VA VA |
$8,780.05
|
|
|
INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$23,339.97
|
|
|
Service Code
|
MSDRG 757
|
| Min. Negotiated Rate |
$11,939.15 |
| Max. Negotiated Rate |
$23,339.97 |
| Rate for Payer: Aetna Medicare |
$13,070.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,709.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,709.41
|
| Rate for Payer: BCBS MAPPO |
$12,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$22,852.96
|
| Rate for Payer: BCN Commercial |
$22,852.96
|
| Rate for Payer: BCN Medicare Advantage |
$12,567.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,567.53
|
| Rate for Payer: Mclaren Medicare |
$12,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,195.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,452.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,824.28
|
| Rate for Payer: Nomi Health Commercial |
$18,471.51
|
| Rate for Payer: PACE Medicare |
$11,939.15
|
| Rate for Payer: PACE SWMI |
$12,567.53
|
| Rate for Payer: PHP Medicare Advantage |
$12,567.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,085.29
|
| Rate for Payer: Priority Health Medicare |
$12,567.53
|
| Rate for Payer: Priority Health Tiered Network |
$18,468.23
|
| Rate for Payer: Railroad Medicare Medicare |
$12,567.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,339.97
|
| Rate for Payer: UHC Core |
$19,526.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,567.53
|
| Rate for Payer: UHC Exchange |
$15,947.07
|
| Rate for Payer: VA VA |
$12,567.53
|
|
|
INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$14,573.74
|
|
|
Service Code
|
MSDRG 759
|
| Min. Negotiated Rate |
$5,835.33 |
| Max. Negotiated Rate |
$14,573.74 |
| Rate for Payer: Aetna Medicare |
$6,388.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,678.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,678.06
|
| Rate for Payer: BCBS MAPPO |
$6,142.45
|
| Rate for Payer: BCBS Trust/PPO |
$14,573.74
|
| Rate for Payer: BCN Commercial |
$14,573.74
|
| Rate for Payer: BCN Medicare Advantage |
$6,142.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,142.45
|
| Rate for Payer: Mclaren Medicare |
$6,142.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,449.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,063.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,756.69
|
| Rate for Payer: Nomi Health Commercial |
$8,560.44
|
| Rate for Payer: PACE Medicare |
$5,835.33
|
| Rate for Payer: PACE SWMI |
$6,142.45
|
| Rate for Payer: PHP Medicare Advantage |
$6,142.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,698.65
|
| Rate for Payer: Priority Health Medicare |
$6,142.45
|
| Rate for Payer: Priority Health Tiered Network |
$8,558.92
|
| Rate for Payer: Railroad Medicare Medicare |
$6,142.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,816.68
|
| Rate for Payer: UHC Core |
$9,049.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,142.45
|
| Rate for Payer: UHC Exchange |
$7,390.51
|
| Rate for Payer: VA VA |
$6,142.45
|
|
|
INFECTIONS OF UPPER RESPIRATORY TRACT
|
Facility
|
IP
|
$9,479.39
|
|
|
Service Code
|
APR-DRG 1134
|
| Min. Negotiated Rate |
$9,027.99 |
| Max. Negotiated Rate |
$9,479.39 |
| Rate for Payer: BCBS Complete |
$9,479.39
|
| Rate for Payer: Mclaren Medicaid |
$9,027.99
|
| Rate for Payer: Meridian Medicaid |
$9,479.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,027.99
|
| Rate for Payer: UHC Medicaid |
$9,027.99
|
| Rate for Payer: UHCCP Medicaid |
$9,027.99
|
|
|
INFECTIONS OF UPPER RESPIRATORY TRACT
|
Facility
|
IP
|
$2,495.75
|
|
|
Service Code
|
APR-DRG 1131
|
| Min. Negotiated Rate |
$2,376.91 |
| Max. Negotiated Rate |
$2,495.75 |
| Rate for Payer: BCBS Complete |
$2,495.75
|
| Rate for Payer: Mclaren Medicaid |
$2,376.91
|
| Rate for Payer: Meridian Medicaid |
$2,495.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,376.91
|
| Rate for Payer: UHC Medicaid |
$2,376.91
|
| Rate for Payer: UHCCP Medicaid |
$2,376.91
|
|
|
INFECTIONS OF UPPER RESPIRATORY TRACT
|
Facility
|
IP
|
$5,184.61
|
|
|
Service Code
|
APR-DRG 1133
|
| Min. Negotiated Rate |
$4,937.72 |
| Max. Negotiated Rate |
$5,184.61 |
| Rate for Payer: BCBS Complete |
$5,184.61
|
| Rate for Payer: Mclaren Medicaid |
$4,937.72
|
| Rate for Payer: Meridian Medicaid |
$5,184.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,937.72
|
| Rate for Payer: UHC Medicaid |
$4,937.72
|
| Rate for Payer: UHCCP Medicaid |
$4,937.72
|
|
|
INFECTIONS OF UPPER RESPIRATORY TRACT
|
Facility
|
IP
|
$3,305.07
|
|
|
Service Code
|
APR-DRG 1132
|
| Min. Negotiated Rate |
$3,147.69 |
| Max. Negotiated Rate |
$3,305.07 |
| Rate for Payer: BCBS Complete |
$3,305.07
|
| Rate for Payer: Mclaren Medicaid |
$3,147.69
|
| Rate for Payer: Meridian Medicaid |
$3,305.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,147.69
|
| Rate for Payer: UHC Medicaid |
$3,147.69
|
| Rate for Payer: UHCCP Medicaid |
$3,147.69
|
|
|
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE
|
Facility
|
IP
|
$9,159.78
|
|
|
Service Code
|
APR-DRG 7102
|
| Min. Negotiated Rate |
$8,723.60 |
| Max. Negotiated Rate |
$9,159.78 |
| Rate for Payer: BCBS Complete |
$9,159.78
|
| Rate for Payer: Mclaren Medicaid |
$8,723.60
|
| Rate for Payer: Meridian Medicaid |
$9,159.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,723.60
|
| Rate for Payer: UHC Medicaid |
$8,723.60
|
| Rate for Payer: UHCCP Medicaid |
$8,723.60
|
|
|
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE
|
Facility
|
IP
|
$22,538.07
|
|
|
Service Code
|
APR-DRG 7104
|
| Min. Negotiated Rate |
$21,464.82 |
| Max. Negotiated Rate |
$22,538.07 |
| Rate for Payer: BCBS Complete |
$22,538.07
|
| Rate for Payer: Mclaren Medicaid |
$21,464.82
|
| Rate for Payer: Meridian Medicaid |
$22,538.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,464.82
|
| Rate for Payer: UHC Medicaid |
$21,464.82
|
| Rate for Payer: UHCCP Medicaid |
$21,464.82
|
|
|
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE
|
Facility
|
IP
|
$15,142.81
|
|
|
Service Code
|
APR-DRG 7103
|
| Min. Negotiated Rate |
$14,421.72 |
| Max. Negotiated Rate |
$15,142.81 |
| Rate for Payer: BCBS Complete |
$15,142.81
|
| Rate for Payer: Mclaren Medicaid |
$14,421.72
|
| Rate for Payer: Meridian Medicaid |
$15,142.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,421.72
|
| Rate for Payer: UHC Medicaid |
$14,421.72
|
| Rate for Payer: UHCCP Medicaid |
$14,421.72
|
|
|
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE
|
Facility
|
IP
|
$8,550.22
|
|
|
Service Code
|
APR-DRG 7101
|
| Min. Negotiated Rate |
$8,143.06 |
| Max. Negotiated Rate |
$8,550.22 |
| Rate for Payer: BCBS Complete |
$8,550.22
|
| Rate for Payer: Mclaren Medicaid |
$8,143.06
|
| Rate for Payer: Meridian Medicaid |
$8,550.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,143.06
|
| Rate for Payer: UHC Medicaid |
$8,143.06
|
| Rate for Payer: UHCCP Medicaid |
$8,143.06
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$32,569.03
|
|
|
Service Code
|
MSDRG 854
|
| Min. Negotiated Rate |
$16,437.34 |
| Max. Negotiated Rate |
$32,569.03 |
| Rate for Payer: Aetna Medicare |
$17,994.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,628.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,628.08
|
| Rate for Payer: BCBS MAPPO |
$17,302.46
|
| Rate for Payer: BCBS Trust/PPO |
$30,292.18
|
| Rate for Payer: BCN Commercial |
$30,292.18
|
| Rate for Payer: BCN Medicare Advantage |
$17,302.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,302.46
|
| Rate for Payer: Mclaren Medicare |
$17,302.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,167.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,897.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,032.71
|
| Rate for Payer: Nomi Health Commercial |
$25,775.49
|
| Rate for Payer: PACE Medicare |
$16,437.34
|
| Rate for Payer: PACE SWMI |
$17,302.46
|
| Rate for Payer: PHP Medicare Advantage |
$17,302.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32,213.65
|
| Rate for Payer: Priority Health Medicare |
$17,302.46
|
| Rate for Payer: Priority Health Tiered Network |
$25,770.91
|
| Rate for Payer: Railroad Medicare Medicare |
$17,302.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,569.03
|
| Rate for Payer: UHC Core |
$27,248.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,302.46
|
| Rate for Payer: UHC Exchange |
$22,252.84
|
| Rate for Payer: VA VA |
$17,302.46
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$88,320.85
|
|
|
Service Code
|
MSDRG 853
|
| Min. Negotiated Rate |
$39,798.31 |
| Max. Negotiated Rate |
$88,320.85 |
| Rate for Payer: Aetna Medicare |
$43,568.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52,366.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52,366.20
|
| Rate for Payer: BCBS MAPPO |
$41,892.96
|
| Rate for Payer: BCBS Trust/PPO |
$88,320.85
|
| Rate for Payer: BCN Commercial |
$88,320.85
|
| Rate for Payer: BCN Medicare Advantage |
$41,892.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41,892.96
|
| Rate for Payer: Mclaren Medicare |
$41,892.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43,987.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48,176.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$46,082.26
|
| Rate for Payer: Nomi Health Commercial |
$63,707.94
|
| Rate for Payer: PACE Medicare |
$39,798.31
|
| Rate for Payer: PACE SWMI |
$41,892.96
|
| Rate for Payer: PHP Medicare Advantage |
$41,892.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$79,620.80
|
| Rate for Payer: Priority Health Medicare |
$41,892.96
|
| Rate for Payer: Priority Health Tiered Network |
$63,696.63
|
| Rate for Payer: Railroad Medicare Medicare |
$41,892.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80,499.18
|
| Rate for Payer: UHC Core |
$67,347.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41,892.96
|
| Rate for Payer: UHC Exchange |
$55,001.19
|
| Rate for Payer: VA VA |
$41,892.96
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,404.36
|
|
|
Service Code
|
MSDRG 855
|
| Min. Negotiated Rate |
$12,457.91 |
| Max. Negotiated Rate |
$24,404.36 |
| Rate for Payer: Aetna Medicare |
$13,638.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,391.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,391.99
|
| Rate for Payer: BCBS MAPPO |
$13,113.59
|
| Rate for Payer: BCBS Trust/PPO |
$23,994.92
|
| Rate for Payer: BCN Commercial |
$23,994.92
|
| Rate for Payer: BCN Medicare Advantage |
$13,113.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,113.59
|
| Rate for Payer: Mclaren Medicare |
$13,113.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,769.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,080.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,424.95
|
| Rate for Payer: Nomi Health Commercial |
$19,313.88
|
| Rate for Payer: PACE Medicare |
$12,457.91
|
| Rate for Payer: PACE SWMI |
$13,113.59
|
| Rate for Payer: PHP Medicare Advantage |
$13,113.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,138.07
|
| Rate for Payer: Priority Health Medicare |
$13,113.59
|
| Rate for Payer: Priority Health Tiered Network |
$19,310.45
|
| Rate for Payer: Railroad Medicare Medicare |
$13,113.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,404.36
|
| Rate for Payer: UHC Core |
$20,417.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,113.59
|
| Rate for Payer: UHC Exchange |
$16,674.32
|
| Rate for Payer: VA VA |
$13,113.59
|
|
|
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$27,146.29
|
|
|
Service Code
|
MSDRG 727
|
| Min. Negotiated Rate |
$12,344.30 |
| Max. Negotiated Rate |
$27,146.29 |
| Rate for Payer: Aetna Medicare |
$13,513.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,242.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,242.50
|
| Rate for Payer: BCBS MAPPO |
$12,994.00
|
| Rate for Payer: BCBS Trust/PPO |
$27,146.29
|
| Rate for Payer: BCN Commercial |
$27,146.29
|
| Rate for Payer: BCN Medicare Advantage |
$12,994.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,994.00
|
| Rate for Payer: Mclaren Medicare |
$12,994.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,643.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,943.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,293.40
|
| Rate for Payer: Nomi Health Commercial |
$19,129.41
|
| Rate for Payer: PACE Medicare |
$12,344.30
|
| Rate for Payer: PACE SWMI |
$12,994.00
|
| Rate for Payer: PHP Medicare Advantage |
$12,994.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,907.52
|
| Rate for Payer: Priority Health Medicare |
$12,994.00
|
| Rate for Payer: Priority Health Tiered Network |
$19,126.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,994.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,171.27
|
| Rate for Payer: UHC Core |
$20,222.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,994.00
|
| Rate for Payer: UHC Exchange |
$16,515.06
|
| Rate for Payer: VA VA |
$12,994.00
|
|
|
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$13,222.56
|
|
|
Service Code
|
MSDRG 728
|
| Min. Negotiated Rate |
$7,007.94 |
| Max. Negotiated Rate |
$13,222.56 |
| Rate for Payer: Aetna Medicare |
$7,671.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,220.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,220.98
|
| Rate for Payer: BCBS MAPPO |
$7,376.78
|
| Rate for Payer: BCBS Trust/PPO |
$11,828.64
|
| Rate for Payer: BCN Commercial |
$11,828.64
|
| Rate for Payer: BCN Medicare Advantage |
$7,376.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,376.78
|
| Rate for Payer: Mclaren Medicare |
$7,376.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,745.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,483.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,114.46
|
| Rate for Payer: Nomi Health Commercial |
$10,464.48
|
| Rate for Payer: PACE Medicare |
$7,007.94
|
| Rate for Payer: PACE SWMI |
$7,376.78
|
| Rate for Payer: PHP Medicare Advantage |
$7,376.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13,078.28
|
| Rate for Payer: Priority Health Medicare |
$7,376.78
|
| Rate for Payer: Priority Health Tiered Network |
$10,462.62
|
| Rate for Payer: Railroad Medicare Medicare |
$7,376.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,222.56
|
| Rate for Payer: UHC Core |
$11,062.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,376.78
|
| Rate for Payer: UHC Exchange |
$9,034.33
|
| Rate for Payer: VA VA |
$7,376.78
|
|
|
INFLAMMATORY BOWEL DISEASE
|
Facility
|
IP
|
$11,489.07
|
|
|
Service Code
|
APR-DRG 2454
|
| Min. Negotiated Rate |
$10,941.97 |
| Max. Negotiated Rate |
$11,489.07 |
| Rate for Payer: BCBS Complete |
$11,489.07
|
| Rate for Payer: Mclaren Medicaid |
$10,941.97
|
| Rate for Payer: Meridian Medicaid |
$11,489.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,941.97
|
| Rate for Payer: UHC Medicaid |
$10,941.97
|
| Rate for Payer: UHCCP Medicaid |
$10,941.97
|
|
|
INFLAMMATORY BOWEL DISEASE
|
Facility
|
IP
|
$8,081.69
|
|
|
Service Code
|
APR-DRG 2453
|
| Min. Negotiated Rate |
$7,696.85 |
| Max. Negotiated Rate |
$8,081.69 |
| Rate for Payer: BCBS Complete |
$8,081.69
|
| Rate for Payer: Mclaren Medicaid |
$7,696.85
|
| Rate for Payer: Meridian Medicaid |
$8,081.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,696.85
|
| Rate for Payer: UHC Medicaid |
$7,696.85
|
| Rate for Payer: UHCCP Medicaid |
$7,696.85
|
|
|
INFLAMMATORY BOWEL DISEASE
|
Facility
|
IP
|
$5,207.61
|
|
|
Service Code
|
APR-DRG 2452
|
| Min. Negotiated Rate |
$4,959.63 |
| Max. Negotiated Rate |
$5,207.61 |
| Rate for Payer: BCBS Complete |
$5,207.61
|
| Rate for Payer: Mclaren Medicaid |
$4,959.63
|
| Rate for Payer: Meridian Medicaid |
$5,207.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,959.63
|
| Rate for Payer: UHC Medicaid |
$4,959.63
|
| Rate for Payer: UHCCP Medicaid |
$4,959.63
|
|
|
INFLAMMATORY BOWEL DISEASE
|
Facility
|
IP
|
$3,673.72
|
|
|
Service Code
|
APR-DRG 2451
|
| Min. Negotiated Rate |
$3,498.78 |
| Max. Negotiated Rate |
$3,673.72 |
| Rate for Payer: BCBS Complete |
$3,673.72
|
| Rate for Payer: Mclaren Medicaid |
$3,498.78
|
| Rate for Payer: Meridian Medicaid |
$3,673.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,498.78
|
| Rate for Payer: UHC Medicaid |
$3,498.78
|
| Rate for Payer: UHCCP Medicaid |
$3,498.78
|
|
|
INFLAMMATORY BOWEL DISEASE WITH CC
|
Facility
|
IP
|
$21,378.84
|
|
|
Service Code
|
MSDRG 386
|
| Min. Negotiated Rate |
$8,319.59 |
| Max. Negotiated Rate |
$21,378.84 |
| Rate for Payer: Aetna Medicare |
$9,107.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,946.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,946.83
|
| Rate for Payer: BCBS MAPPO |
$8,757.46
|
| Rate for Payer: BCBS Trust/PPO |
$21,378.84
|
| Rate for Payer: BCN Commercial |
$21,378.84
|
| Rate for Payer: BCN Medicare Advantage |
$8,757.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,757.46
|
| Rate for Payer: Mclaren Medicare |
$8,757.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,195.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,071.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,633.21
|
| Rate for Payer: Nomi Health Commercial |
$12,594.27
|
| Rate for Payer: PACE Medicare |
$8,319.59
|
| Rate for Payer: PACE SWMI |
$8,757.46
|
| Rate for Payer: PHP Medicare Advantage |
$8,757.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15,740.05
|
| Rate for Payer: Priority Health Medicare |
$8,757.46
|
| Rate for Payer: Priority Health Tiered Network |
$12,592.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8,757.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,913.69
|
| Rate for Payer: UHC Core |
$13,313.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,757.46
|
| Rate for Payer: UHC Exchange |
$10,873.05
|
| Rate for Payer: VA VA |
$8,757.46
|
|
|
INFLAMMATORY BOWEL DISEASE WITH MCC
|
Facility
|
IP
|
$28,697.28
|
|
|
Service Code
|
MSDRG 385
|
| Min. Negotiated Rate |
$13,134.01 |
| Max. Negotiated Rate |
$28,697.28 |
| Rate for Payer: Aetna Medicare |
$14,378.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,281.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,281.59
|
| Rate for Payer: BCBS MAPPO |
$13,825.27
|
| Rate for Payer: BCBS Trust/PPO |
$28,697.28
|
| Rate for Payer: BCN Commercial |
$28,697.28
|
| Rate for Payer: BCN Medicare Advantage |
$13,825.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,825.27
|
| Rate for Payer: Mclaren Medicare |
$13,825.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,516.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,899.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,207.80
|
| Rate for Payer: Nomi Health Commercial |
$20,411.67
|
| Rate for Payer: PACE Medicare |
$13,134.01
|
| Rate for Payer: PACE SWMI |
$13,825.27
|
| Rate for Payer: PHP Medicare Advantage |
$13,825.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,510.06
|
| Rate for Payer: Priority Health Medicare |
$13,825.27
|
| Rate for Payer: Priority Health Tiered Network |
$20,408.05
|
| Rate for Payer: Railroad Medicare Medicare |
$13,825.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,791.49
|
| Rate for Payer: UHC Core |
$21,577.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,825.27
|
| Rate for Payer: UHC Exchange |
$17,622.08
|
| Rate for Payer: VA VA |
$13,825.27
|
|
|
INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$14,623.15
|
|
|
Service Code
|
MSDRG 387
|
| Min. Negotiated Rate |
$5,975.97 |
| Max. Negotiated Rate |
$14,623.15 |
| Rate for Payer: Aetna Medicare |
$6,542.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,863.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,863.11
|
| Rate for Payer: BCBS MAPPO |
$6,290.49
|
| Rate for Payer: BCBS Trust/PPO |
$14,623.15
|
| Rate for Payer: BCN Commercial |
$14,623.15
|
| Rate for Payer: BCN Medicare Advantage |
$6,290.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,290.49
|
| Rate for Payer: Mclaren Medicare |
$6,290.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,605.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,234.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,919.54
|
| Rate for Payer: Nomi Health Commercial |
$8,788.77
|
| Rate for Payer: PACE Medicare |
$5,975.97
|
| Rate for Payer: PACE SWMI |
$6,290.49
|
| Rate for Payer: PHP Medicare Advantage |
$6,290.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,984.01
|
| Rate for Payer: Priority Health Medicare |
$6,290.49
|
| Rate for Payer: Priority Health Tiered Network |
$8,787.21
|
| Rate for Payer: Railroad Medicare Medicare |
$6,290.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,105.19
|
| Rate for Payer: UHC Core |
$9,290.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,290.49
|
| Rate for Payer: UHC Exchange |
$7,587.64
|
| Rate for Payer: VA VA |
$6,290.49
|
|
