|
MAJOR ESOPHAGEAL DISORDERS WITH CC
|
Facility
|
IP
|
$23,031.39
|
|
|
Service Code
|
MSDRG 369
|
| Min. Negotiated Rate |
$8,509.47 |
| Max. Negotiated Rate |
$23,031.39 |
| Rate for Payer: Aetna Medicare |
$9,315.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,196.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,196.67
|
| Rate for Payer: BCBS MAPPO |
$8,957.34
|
| Rate for Payer: BCBS Trust/PPO |
$23,031.39
|
| Rate for Payer: BCN Commercial |
$23,031.39
|
| Rate for Payer: BCN Medicare Advantage |
$8,957.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,957.34
|
| Rate for Payer: Mclaren Medicare |
$8,957.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,405.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,300.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,853.07
|
| Rate for Payer: Nomi Health Commercial |
$12,902.58
|
| Rate for Payer: PACE Medicare |
$8,509.47
|
| Rate for Payer: PACE SWMI |
$8,957.34
|
| Rate for Payer: PHP Medicare Advantage |
$8,957.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,125.36
|
| Rate for Payer: Priority Health Medicare |
$8,957.34
|
| Rate for Payer: Priority Health Tiered Network |
$12,900.29
|
| Rate for Payer: Railroad Medicare Medicare |
$8,957.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,303.26
|
| Rate for Payer: UHC Core |
$13,639.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,957.34
|
| Rate for Payer: UHC Exchange |
$11,139.23
|
| Rate for Payer: VA VA |
$8,957.34
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITH MCC
|
Facility
|
IP
|
$31,760.81
|
|
|
Service Code
|
MSDRG 368
|
| Min. Negotiated Rate |
$13,210.27 |
| Max. Negotiated Rate |
$31,760.81 |
| Rate for Payer: Aetna Medicare |
$14,461.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,381.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,381.94
|
| Rate for Payer: BCBS MAPPO |
$13,905.55
|
| Rate for Payer: BCBS Trust/PPO |
$31,760.81
|
| Rate for Payer: BCN Commercial |
$31,760.81
|
| Rate for Payer: BCN Medicare Advantage |
$13,905.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,905.55
|
| Rate for Payer: Mclaren Medicare |
$13,905.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,600.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,991.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,296.10
|
| Rate for Payer: Nomi Health Commercial |
$20,535.51
|
| Rate for Payer: PACE Medicare |
$13,210.27
|
| Rate for Payer: PACE SWMI |
$13,905.55
|
| Rate for Payer: PHP Medicare Advantage |
$13,905.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,664.83
|
| Rate for Payer: Priority Health Medicare |
$13,905.55
|
| Rate for Payer: Priority Health Tiered Network |
$20,531.86
|
| Rate for Payer: Railroad Medicare Medicare |
$13,905.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,947.97
|
| Rate for Payer: UHC Core |
$21,708.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,905.55
|
| Rate for Payer: UHC Exchange |
$17,728.99
|
| Rate for Payer: VA VA |
$13,905.55
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$15,858.44
|
|
|
Service Code
|
MSDRG 370
|
| Min. Negotiated Rate |
$6,130.87 |
| Max. Negotiated Rate |
$15,858.44 |
| Rate for Payer: Aetna Medicare |
$6,711.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,066.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,066.94
|
| Rate for Payer: BCBS MAPPO |
$6,453.55
|
| Rate for Payer: BCBS Trust/PPO |
$15,858.44
|
| Rate for Payer: BCN Commercial |
$15,858.44
|
| Rate for Payer: BCN Medicare Advantage |
$6,453.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,453.55
|
| Rate for Payer: Mclaren Medicare |
$6,453.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,776.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,421.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,098.90
|
| Rate for Payer: Nomi Health Commercial |
$9,040.32
|
| Rate for Payer: PACE Medicare |
$6,130.87
|
| Rate for Payer: PACE SWMI |
$6,453.55
|
| Rate for Payer: PHP Medicare Advantage |
$6,453.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,298.40
|
| Rate for Payer: Priority Health Medicare |
$6,453.55
|
| Rate for Payer: Priority Health Tiered Network |
$9,038.72
|
| Rate for Payer: Railroad Medicare Medicare |
$6,453.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,423.04
|
| Rate for Payer: UHC Core |
$9,556.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,453.55
|
| Rate for Payer: UHC Exchange |
$7,804.81
|
| Rate for Payer: VA VA |
$6,453.55
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$6,878.31
|
|
|
Service Code
|
APR-DRG 2483
|
| Min. Negotiated Rate |
$6,550.77 |
| Max. Negotiated Rate |
$6,878.31 |
| Rate for Payer: BCBS Complete |
$6,878.31
|
| Rate for Payer: Mclaren Medicaid |
$6,550.77
|
| Rate for Payer: Meridian Medicaid |
$6,878.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,550.77
|
| Rate for Payer: UHC Medicaid |
$6,550.77
|
| Rate for Payer: UHCCP Medicaid |
$6,550.77
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$4,018.15
|
|
|
Service Code
|
APR-DRG 2481
|
| Min. Negotiated Rate |
$3,826.81 |
| Max. Negotiated Rate |
$4,018.15 |
| Rate for Payer: BCBS Complete |
$4,018.15
|
| Rate for Payer: Mclaren Medicaid |
$3,826.81
|
| Rate for Payer: Meridian Medicaid |
$4,018.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,826.81
|
| Rate for Payer: UHC Medicaid |
$3,826.81
|
| Rate for Payer: UHCCP Medicaid |
$3,826.81
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$11,194.88
|
|
|
Service Code
|
APR-DRG 2484
|
| Min. Negotiated Rate |
$10,661.79 |
| Max. Negotiated Rate |
$11,194.88 |
| Rate for Payer: BCBS Complete |
$11,194.88
|
| Rate for Payer: Mclaren Medicaid |
$10,661.79
|
| Rate for Payer: Meridian Medicaid |
$11,194.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,661.79
|
| Rate for Payer: UHC Medicaid |
$10,661.79
|
| Rate for Payer: UHCCP Medicaid |
$10,661.79
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$5,243.93
|
|
|
Service Code
|
APR-DRG 2482
|
| Min. Negotiated Rate |
$4,994.22 |
| Max. Negotiated Rate |
$5,243.93 |
| Rate for Payer: BCBS Complete |
$5,243.93
|
| Rate for Payer: Mclaren Medicaid |
$4,994.22
|
| Rate for Payer: Meridian Medicaid |
$5,243.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,994.22
|
| Rate for Payer: UHC Medicaid |
$4,994.22
|
| Rate for Payer: UHCCP Medicaid |
$4,994.22
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC
|
Facility
|
IP
|
$18,609.03
|
|
|
Service Code
|
MSDRG 372
|
| Min. Negotiated Rate |
$8,674.71 |
| Max. Negotiated Rate |
$18,609.03 |
| Rate for Payer: Aetna Medicare |
$9,496.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,414.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,414.09
|
| Rate for Payer: BCBS MAPPO |
$9,131.27
|
| Rate for Payer: BCBS Trust/PPO |
$18,609.03
|
| Rate for Payer: BCN Commercial |
$18,609.03
|
| Rate for Payer: BCN Medicare Advantage |
$9,131.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,131.27
|
| Rate for Payer: Mclaren Medicare |
$9,131.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,587.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,500.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,044.40
|
| Rate for Payer: Nomi Health Commercial |
$13,170.90
|
| Rate for Payer: PACE Medicare |
$8,674.71
|
| Rate for Payer: PACE SWMI |
$9,131.27
|
| Rate for Payer: PHP Medicare Advantage |
$9,131.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,460.70
|
| Rate for Payer: Priority Health Medicare |
$9,131.27
|
| Rate for Payer: Priority Health Tiered Network |
$13,168.56
|
| Rate for Payer: Railroad Medicare Medicare |
$9,131.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,642.30
|
| Rate for Payer: UHC Core |
$13,923.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,131.27
|
| Rate for Payer: UHC Exchange |
$11,370.88
|
| Rate for Payer: VA VA |
$9,131.27
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC
|
Facility
|
IP
|
$35,842.77
|
|
|
Service Code
|
MSDRG 371
|
| Min. Negotiated Rate |
$14,649.82 |
| Max. Negotiated Rate |
$35,842.77 |
| Rate for Payer: Aetna Medicare |
$16,037.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,276.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,276.08
|
| Rate for Payer: BCBS MAPPO |
$15,420.86
|
| Rate for Payer: BCBS Trust/PPO |
$35,842.77
|
| Rate for Payer: BCN Commercial |
$35,842.77
|
| Rate for Payer: BCN Medicare Advantage |
$15,420.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,420.86
|
| Rate for Payer: Mclaren Medicare |
$15,420.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,191.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,733.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,962.95
|
| Rate for Payer: Nomi Health Commercial |
$22,872.99
|
| Rate for Payer: PACE Medicare |
$14,649.82
|
| Rate for Payer: PACE SWMI |
$15,420.86
|
| Rate for Payer: PHP Medicare Advantage |
$15,420.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,586.17
|
| Rate for Payer: Priority Health Medicare |
$15,420.86
|
| Rate for Payer: Priority Health Tiered Network |
$22,868.93
|
| Rate for Payer: Railroad Medicare Medicare |
$15,420.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,901.53
|
| Rate for Payer: UHC Core |
$24,179.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,420.86
|
| Rate for Payer: UHC Exchange |
$19,747.01
|
| Rate for Payer: VA VA |
$15,420.86
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$16,031.38
|
|
|
Service Code
|
MSDRG 373
|
| Min. Negotiated Rate |
$6,342.20 |
| Max. Negotiated Rate |
$16,031.38 |
| Rate for Payer: Aetna Medicare |
$6,943.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,345.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,345.00
|
| Rate for Payer: BCBS MAPPO |
$6,676.00
|
| Rate for Payer: BCBS Trust/PPO |
$16,031.38
|
| Rate for Payer: BCN Commercial |
$16,031.38
|
| Rate for Payer: BCN Medicare Advantage |
$6,676.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,676.00
|
| Rate for Payer: Mclaren Medicare |
$6,676.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,009.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,677.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,343.60
|
| Rate for Payer: Nomi Health Commercial |
$9,383.46
|
| Rate for Payer: PACE Medicare |
$6,342.20
|
| Rate for Payer: PACE SWMI |
$6,676.00
|
| Rate for Payer: PHP Medicare Advantage |
$6,676.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,727.24
|
| Rate for Payer: Priority Health Medicare |
$6,676.00
|
| Rate for Payer: Priority Health Tiered Network |
$9,381.79
|
| Rate for Payer: Railroad Medicare Medicare |
$6,676.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,856.62
|
| Rate for Payer: UHC Core |
$9,919.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,676.00
|
| Rate for Payer: UHC Exchange |
$8,101.05
|
| Rate for Payer: VA VA |
$6,676.00
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$70,214.17
|
|
|
Service Code
|
MSDRG 141
|
| Min. Negotiated Rate |
$17,891.20 |
| Max. Negotiated Rate |
$70,214.17 |
| Rate for Payer: Aetna Medicare |
$19,586.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,541.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,541.05
|
| Rate for Payer: BCBS MAPPO |
$18,832.84
|
| Rate for Payer: BCBS Trust/PPO |
$70,214.17
|
| Rate for Payer: BCN Commercial |
$70,214.17
|
| Rate for Payer: BCN Medicare Advantage |
$18,832.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,832.84
|
| Rate for Payer: Mclaren Medicare |
$18,832.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,774.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,657.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,716.12
|
| Rate for Payer: Nomi Health Commercial |
$28,136.19
|
| Rate for Payer: PACE Medicare |
$17,891.20
|
| Rate for Payer: PACE SWMI |
$18,832.84
|
| Rate for Payer: PHP Medicare Advantage |
$18,832.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35,164.00
|
| Rate for Payer: Priority Health Medicare |
$18,832.84
|
| Rate for Payer: Priority Health Tiered Network |
$28,131.20
|
| Rate for Payer: Railroad Medicare Medicare |
$18,832.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,551.93
|
| Rate for Payer: UHC Core |
$29,743.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,832.84
|
| Rate for Payer: UHC Exchange |
$24,290.91
|
| Rate for Payer: VA VA |
$18,832.84
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$91,993.79
|
|
|
Service Code
|
MSDRG 140
|
| Min. Negotiated Rate |
$34,449.25 |
| Max. Negotiated Rate |
$91,993.79 |
| Rate for Payer: Aetna Medicare |
$37,712.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,327.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,327.96
|
| Rate for Payer: BCBS MAPPO |
$36,262.37
|
| Rate for Payer: BCBS Trust/PPO |
$91,993.79
|
| Rate for Payer: BCN Commercial |
$91,993.79
|
| Rate for Payer: BCN Medicare Advantage |
$36,262.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,262.37
|
| Rate for Payer: Mclaren Medicare |
$36,262.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,075.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41,701.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$39,888.61
|
| Rate for Payer: Nomi Health Commercial |
$55,022.37
|
| Rate for Payer: PACE Medicare |
$34,449.25
|
| Rate for Payer: PACE SWMI |
$36,262.37
|
| Rate for Payer: PHP Medicare Advantage |
$36,262.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$68,765.76
|
| Rate for Payer: Priority Health Medicare |
$36,262.37
|
| Rate for Payer: Priority Health Tiered Network |
$55,012.60
|
| Rate for Payer: Railroad Medicare Medicare |
$36,262.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69,524.39
|
| Rate for Payer: UHC Core |
$58,165.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36,262.37
|
| Rate for Payer: UHC Exchange |
$47,502.65
|
| Rate for Payer: VA VA |
$36,262.37
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$51,923.57
|
|
|
Service Code
|
MSDRG 142
|
| Min. Negotiated Rate |
$13,246.02 |
| Max. Negotiated Rate |
$51,923.57 |
| Rate for Payer: Aetna Medicare |
$14,500.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,428.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,428.97
|
| Rate for Payer: BCBS MAPPO |
$13,943.18
|
| Rate for Payer: BCBS Trust/PPO |
$51,923.57
|
| Rate for Payer: BCN Commercial |
$51,923.57
|
| Rate for Payer: BCN Medicare Advantage |
$13,943.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,943.18
|
| Rate for Payer: Mclaren Medicare |
$13,943.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,640.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,034.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,337.50
|
| Rate for Payer: Nomi Health Commercial |
$20,593.56
|
| Rate for Payer: PACE Medicare |
$13,246.02
|
| Rate for Payer: PACE SWMI |
$13,943.18
|
| Rate for Payer: PHP Medicare Advantage |
$13,943.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,737.38
|
| Rate for Payer: Priority Health Medicare |
$13,943.18
|
| Rate for Payer: Priority Health Tiered Network |
$20,589.90
|
| Rate for Payer: Railroad Medicare Medicare |
$13,943.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,021.32
|
| Rate for Payer: UHC Core |
$21,770.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,943.18
|
| Rate for Payer: UHC Exchange |
$17,779.11
|
| Rate for Payer: VA VA |
$13,943.18
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
|
IP
|
$23,179.62
|
|
|
Service Code
|
MSDRG 809
|
| Min. Negotiated Rate |
$10,620.34 |
| Max. Negotiated Rate |
$23,179.62 |
| Rate for Payer: Aetna Medicare |
$11,626.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,974.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,974.14
|
| Rate for Payer: BCBS MAPPO |
$11,179.31
|
| Rate for Payer: BCBS Trust/PPO |
$23,179.62
|
| Rate for Payer: BCN Commercial |
$23,179.62
|
| Rate for Payer: BCN Medicare Advantage |
$11,179.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,179.31
|
| Rate for Payer: Mclaren Medicare |
$11,179.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,738.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,856.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,297.24
|
| Rate for Payer: Nomi Health Commercial |
$16,330.11
|
| Rate for Payer: PACE Medicare |
$10,620.34
|
| Rate for Payer: PACE SWMI |
$11,179.31
|
| Rate for Payer: PHP Medicare Advantage |
$11,179.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,409.02
|
| Rate for Payer: Priority Health Medicare |
$11,179.31
|
| Rate for Payer: Priority Health Tiered Network |
$16,327.21
|
| Rate for Payer: Railroad Medicare Medicare |
$11,179.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,634.17
|
| Rate for Payer: UHC Core |
$17,263.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,179.31
|
| Rate for Payer: UHC Exchange |
$14,098.33
|
| Rate for Payer: VA VA |
$11,179.31
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
|
IP
|
$47,586.31
|
|
|
Service Code
|
MSDRG 808
|
| Min. Negotiated Rate |
$18,104.12 |
| Max. Negotiated Rate |
$47,586.31 |
| Rate for Payer: Aetna Medicare |
$19,819.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,821.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,821.21
|
| Rate for Payer: BCBS MAPPO |
$19,056.97
|
| Rate for Payer: BCBS Trust/PPO |
$47,586.31
|
| Rate for Payer: BCN Commercial |
$47,586.31
|
| Rate for Payer: BCN Medicare Advantage |
$19,056.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,056.97
|
| Rate for Payer: Mclaren Medicare |
$19,056.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,009.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,915.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,962.67
|
| Rate for Payer: Nomi Health Commercial |
$28,481.91
|
| Rate for Payer: PACE Medicare |
$18,104.12
|
| Rate for Payer: PACE SWMI |
$19,056.97
|
| Rate for Payer: PHP Medicare Advantage |
$19,056.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35,596.07
|
| Rate for Payer: Priority Health Medicare |
$19,056.97
|
| Rate for Payer: Priority Health Tiered Network |
$28,476.85
|
| Rate for Payer: Railroad Medicare Medicare |
$19,056.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,988.77
|
| Rate for Payer: UHC Core |
$30,109.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,056.97
|
| Rate for Payer: UHC Exchange |
$24,589.38
|
| Rate for Payer: VA VA |
$19,056.97
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$20,525.11
|
|
|
Service Code
|
MSDRG 810
|
| Min. Negotiated Rate |
$8,878.09 |
| Max. Negotiated Rate |
$20,525.11 |
| Rate for Payer: Aetna Medicare |
$9,719.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,681.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,681.70
|
| Rate for Payer: BCBS MAPPO |
$9,345.36
|
| Rate for Payer: BCBS Trust/PPO |
$20,525.11
|
| Rate for Payer: BCN Commercial |
$20,525.11
|
| Rate for Payer: BCN Medicare Advantage |
$9,345.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,345.36
|
| Rate for Payer: Mclaren Medicare |
$9,345.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,812.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,747.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,279.90
|
| Rate for Payer: Nomi Health Commercial |
$13,501.14
|
| Rate for Payer: PACE Medicare |
$8,878.09
|
| Rate for Payer: PACE SWMI |
$9,345.36
|
| Rate for Payer: PHP Medicare Advantage |
$9,345.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,873.43
|
| Rate for Payer: Priority Health Medicare |
$9,345.36
|
| Rate for Payer: Priority Health Tiered Network |
$13,498.74
|
| Rate for Payer: Railroad Medicare Medicare |
$9,345.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,059.58
|
| Rate for Payer: UHC Core |
$14,272.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,345.36
|
| Rate for Payer: UHC Exchange |
$11,655.98
|
| Rate for Payer: VA VA |
$9,345.36
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$5,130.73
|
|
|
Service Code
|
APR-DRG 6602
|
| Min. Negotiated Rate |
$4,886.41 |
| Max. Negotiated Rate |
$5,130.73 |
| Rate for Payer: BCBS Complete |
$5,130.73
|
| Rate for Payer: Mclaren Medicaid |
$4,886.41
|
| Rate for Payer: Meridian Medicaid |
$5,130.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,886.41
|
| Rate for Payer: UHC Medicaid |
$4,886.41
|
| Rate for Payer: UHCCP Medicaid |
$4,886.41
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$18,261.44
|
|
|
Service Code
|
APR-DRG 6604
|
| Min. Negotiated Rate |
$17,391.85 |
| Max. Negotiated Rate |
$18,261.44 |
| Rate for Payer: BCBS Complete |
$18,261.44
|
| Rate for Payer: Mclaren Medicaid |
$17,391.85
|
| Rate for Payer: Meridian Medicaid |
$18,261.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,391.85
|
| Rate for Payer: UHC Medicaid |
$17,391.85
|
| Rate for Payer: UHCCP Medicaid |
$17,391.85
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$3,907.37
|
|
|
Service Code
|
APR-DRG 6601
|
| Min. Negotiated Rate |
$3,721.31 |
| Max. Negotiated Rate |
$3,907.37 |
| Rate for Payer: BCBS Complete |
$3,907.37
|
| Rate for Payer: Mclaren Medicaid |
$3,721.31
|
| Rate for Payer: Meridian Medicaid |
$3,907.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,721.31
|
| Rate for Payer: UHC Medicaid |
$3,721.31
|
| Rate for Payer: UHCCP Medicaid |
$3,721.31
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$9,417.04
|
|
|
Service Code
|
APR-DRG 6603
|
| Min. Negotiated Rate |
$8,968.61 |
| Max. Negotiated Rate |
$9,417.04 |
| Rate for Payer: BCBS Complete |
$9,417.04
|
| Rate for Payer: Mclaren Medicaid |
$8,968.61
|
| Rate for Payer: Meridian Medicaid |
$9,417.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,968.61
|
| Rate for Payer: UHC Medicaid |
$8,968.61
|
| Rate for Payer: UHCCP Medicaid |
$8,968.61
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$77,293.78
|
|
|
Service Code
|
MSDRG 469
|
| Min. Negotiated Rate |
$24,660.76 |
| Max. Negotiated Rate |
$77,293.78 |
| Rate for Payer: Aetna Medicare |
$26,997.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,448.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,448.36
|
| Rate for Payer: BCBS MAPPO |
$25,958.69
|
| Rate for Payer: BCBS Trust/PPO |
$77,293.78
|
| Rate for Payer: BCN Commercial |
$77,293.78
|
| Rate for Payer: BCN Medicare Advantage |
$25,958.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,958.69
|
| Rate for Payer: Mclaren Medicare |
$25,958.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,256.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,852.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,554.56
|
| Rate for Payer: Nomi Health Commercial |
$39,128.28
|
| Rate for Payer: PACE Medicare |
$24,660.76
|
| Rate for Payer: PACE SWMI |
$25,958.69
|
| Rate for Payer: PHP Medicare Advantage |
$25,958.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$48,901.68
|
| Rate for Payer: Priority Health Medicare |
$25,958.69
|
| Rate for Payer: Priority Health Tiered Network |
$39,121.33
|
| Rate for Payer: Railroad Medicare Medicare |
$25,958.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,441.16
|
| Rate for Payer: UHC Core |
$41,363.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25,958.69
|
| Rate for Payer: UHC Exchange |
$33,780.75
|
| Rate for Payer: VA VA |
$25,958.69
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$41,009.05
|
|
|
Service Code
|
MSDRG 470
|
| Min. Negotiated Rate |
$15,887.58 |
| Max. Negotiated Rate |
$41,009.05 |
| Rate for Payer: Aetna Medicare |
$17,392.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,904.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,904.71
|
| Rate for Payer: BCBS MAPPO |
$16,723.77
|
| Rate for Payer: BCBS Trust/PPO |
$41,009.05
|
| Rate for Payer: BCN Commercial |
$41,009.05
|
| Rate for Payer: BCN Medicare Advantage |
$16,723.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,723.77
|
| Rate for Payer: Mclaren Medicare |
$16,723.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,559.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,232.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,396.15
|
| Rate for Payer: Nomi Health Commercial |
$24,882.81
|
| Rate for Payer: PACE Medicare |
$15,887.58
|
| Rate for Payer: PACE SWMI |
$16,723.77
|
| Rate for Payer: PHP Medicare Advantage |
$16,723.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31,098.00
|
| Rate for Payer: Priority Health Medicare |
$16,723.77
|
| Rate for Payer: Priority Health Tiered Network |
$24,878.39
|
| Rate for Payer: Railroad Medicare Medicare |
$16,723.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,441.07
|
| Rate for Payer: UHC Core |
$26,304.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,723.77
|
| Rate for Payer: UHC Exchange |
$21,482.16
|
| Rate for Payer: VA VA |
$16,723.77
|
|
|
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$45,181.97
|
|
|
Service Code
|
MSDRG 483
|
| Min. Negotiated Rate |
$22,584.84 |
| Max. Negotiated Rate |
$45,181.97 |
| Rate for Payer: Aetna Medicare |
$24,724.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,716.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,716.90
|
| Rate for Payer: BCBS MAPPO |
$23,773.52
|
| Rate for Payer: BCBS Trust/PPO |
$43,880.42
|
| Rate for Payer: BCN Commercial |
$43,880.42
|
| Rate for Payer: BCN Medicare Advantage |
$23,773.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,773.52
|
| Rate for Payer: Mclaren Medicare |
$23,773.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,962.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,339.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$26,150.87
|
| Rate for Payer: Nomi Health Commercial |
$35,757.51
|
| Rate for Payer: PACE Medicare |
$22,584.84
|
| Rate for Payer: PACE SWMI |
$23,773.52
|
| Rate for Payer: PHP Medicare Advantage |
$23,773.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$44,688.96
|
| Rate for Payer: Priority Health Medicare |
$23,773.52
|
| Rate for Payer: Priority Health Tiered Network |
$35,751.16
|
| Rate for Payer: Railroad Medicare Medicare |
$23,773.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45,181.97
|
| Rate for Payer: UHC Core |
$37,800.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23,773.52
|
| Rate for Payer: UHC Exchange |
$30,870.65
|
| Rate for Payer: VA VA |
$23,773.52
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$12,315.34
|
|
|
Service Code
|
APR-DRG 2312
|
| Min. Negotiated Rate |
$11,728.89 |
| Max. Negotiated Rate |
$12,315.34 |
| Rate for Payer: BCBS Complete |
$12,315.34
|
| Rate for Payer: Mclaren Medicaid |
$11,728.89
|
| Rate for Payer: Meridian Medicaid |
$12,315.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,728.89
|
| Rate for Payer: UHC Medicaid |
$11,728.89
|
| Rate for Payer: UHCCP Medicaid |
$11,728.89
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$9,530.24
|
|
|
Service Code
|
APR-DRG 2311
|
| Min. Negotiated Rate |
$9,076.42 |
| Max. Negotiated Rate |
$9,530.24 |
| Rate for Payer: BCBS Complete |
$9,530.24
|
| Rate for Payer: Mclaren Medicaid |
$9,076.42
|
| Rate for Payer: Meridian Medicaid |
$9,530.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,076.42
|
| Rate for Payer: UHC Medicaid |
$9,076.42
|
| Rate for Payer: UHCCP Medicaid |
$9,076.42
|
|
