|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$26,784.42
|
|
|
Service Code
|
APR-DRG 2314
|
| Min. Negotiated Rate |
$25,508.97 |
| Max. Negotiated Rate |
$26,784.42 |
| Rate for Payer: BCBS Complete |
$26,784.42
|
| Rate for Payer: Mclaren Medicaid |
$25,508.97
|
| Rate for Payer: Meridian Medicaid |
$26,784.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,508.97
|
| Rate for Payer: UHC Medicaid |
$25,508.97
|
| Rate for Payer: UHCCP Medicaid |
$25,508.97
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$17,602.85
|
|
|
Service Code
|
APR-DRG 2313
|
| Min. Negotiated Rate |
$16,764.62 |
| Max. Negotiated Rate |
$17,602.85 |
| Rate for Payer: BCBS Complete |
$17,602.85
|
| Rate for Payer: Mclaren Medicaid |
$16,764.62
|
| Rate for Payer: Meridian Medicaid |
$17,602.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,764.62
|
| Rate for Payer: UHC Medicaid |
$16,764.62
|
| Rate for Payer: UHCCP Medicaid |
$16,764.62
|
|
|
MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$60,707.89
|
|
|
Service Code
|
MSDRG 707
|
| Min. Negotiated Rate |
$16,454.83 |
| Max. Negotiated Rate |
$60,707.89 |
| Rate for Payer: Aetna Medicare |
$18,013.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,651.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,651.09
|
| Rate for Payer: BCBS MAPPO |
$17,320.87
|
| Rate for Payer: BCBS Trust/PPO |
$60,707.89
|
| Rate for Payer: BCN Commercial |
$60,707.89
|
| Rate for Payer: BCN Medicare Advantage |
$17,320.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,320.87
|
| Rate for Payer: Mclaren Medicare |
$17,320.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,186.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,919.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,052.96
|
| Rate for Payer: Nomi Health Commercial |
$25,803.87
|
| Rate for Payer: PACE Medicare |
$16,454.83
|
| Rate for Payer: PACE SWMI |
$17,320.87
|
| Rate for Payer: PHP Medicare Advantage |
$17,320.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32,249.12
|
| Rate for Payer: Priority Health Medicare |
$17,320.87
|
| Rate for Payer: Priority Health Tiered Network |
$25,799.29
|
| Rate for Payer: Railroad Medicare Medicare |
$17,320.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,604.89
|
| Rate for Payer: UHC Core |
$27,278.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,320.87
|
| Rate for Payer: UHC Exchange |
$22,277.34
|
| Rate for Payer: VA VA |
$17,320.87
|
|
|
MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$36,056.89
|
|
|
Service Code
|
MSDRG 708
|
| Min. Negotiated Rate |
$12,751.87 |
| Max. Negotiated Rate |
$36,056.89 |
| Rate for Payer: Aetna Medicare |
$13,959.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,778.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,778.78
|
| Rate for Payer: BCBS MAPPO |
$13,423.02
|
| Rate for Payer: BCBS Trust/PPO |
$36,056.89
|
| Rate for Payer: BCN Commercial |
$36,056.89
|
| Rate for Payer: BCN Medicare Advantage |
$13,423.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,423.02
|
| Rate for Payer: Mclaren Medicare |
$13,423.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,094.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,436.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,765.32
|
| Rate for Payer: Nomi Health Commercial |
$19,791.18
|
| Rate for Payer: PACE Medicare |
$12,751.87
|
| Rate for Payer: PACE SWMI |
$13,423.02
|
| Rate for Payer: PHP Medicare Advantage |
$13,423.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,734.59
|
| Rate for Payer: Priority Health Medicare |
$13,423.02
|
| Rate for Payer: Priority Health Tiered Network |
$19,787.67
|
| Rate for Payer: Railroad Medicare Medicare |
$13,423.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,007.46
|
| Rate for Payer: UHC Core |
$20,921.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,423.02
|
| Rate for Payer: UHC Exchange |
$17,086.39
|
| Rate for Payer: VA VA |
$13,423.02
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$15,401.28
|
|
|
Service Code
|
APR-DRG 6802
|
| Min. Negotiated Rate |
$14,667.89 |
| Max. Negotiated Rate |
$15,401.28 |
| Rate for Payer: BCBS Complete |
$15,401.28
|
| Rate for Payer: Mclaren Medicaid |
$14,667.89
|
| Rate for Payer: Meridian Medicaid |
$15,401.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,667.89
|
| Rate for Payer: UHC Medicaid |
$14,667.89
|
| Rate for Payer: UHCCP Medicaid |
$14,667.89
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$44,630.01
|
|
|
Service Code
|
APR-DRG 6804
|
| Min. Negotiated Rate |
$42,504.77 |
| Max. Negotiated Rate |
$44,630.01 |
| Rate for Payer: BCBS Complete |
$44,630.01
|
| Rate for Payer: Mclaren Medicaid |
$42,504.77
|
| Rate for Payer: Meridian Medicaid |
$44,630.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$42,504.77
|
| Rate for Payer: UHC Medicaid |
$42,504.77
|
| Rate for Payer: UHCCP Medicaid |
$42,504.77
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$22,444.24
|
|
|
Service Code
|
APR-DRG 6803
|
| Min. Negotiated Rate |
$21,375.47 |
| Max. Negotiated Rate |
$22,444.24 |
| Rate for Payer: BCBS Complete |
$22,444.24
|
| Rate for Payer: Mclaren Medicaid |
$21,375.47
|
| Rate for Payer: Meridian Medicaid |
$22,444.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,375.47
|
| Rate for Payer: UHC Medicaid |
$21,375.47
|
| Rate for Payer: UHCCP Medicaid |
$21,375.47
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$11,523.57
|
|
|
Service Code
|
APR-DRG 6801
|
| Min. Negotiated Rate |
$10,974.83 |
| Max. Negotiated Rate |
$11,523.57 |
| Rate for Payer: BCBS Complete |
$11,523.57
|
| Rate for Payer: Mclaren Medicaid |
$10,974.83
|
| Rate for Payer: Meridian Medicaid |
$11,523.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,974.83
|
| Rate for Payer: UHC Medicaid |
$10,974.83
|
| Rate for Payer: UHCCP Medicaid |
$10,974.83
|
|
|
MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES
|
Facility
|
IP
|
$10,593.19
|
|
|
Service Code
|
APR-DRG 2601
|
| Min. Negotiated Rate |
$10,088.75 |
| Max. Negotiated Rate |
$10,593.19 |
| Rate for Payer: BCBS Complete |
$10,593.19
|
| Rate for Payer: Mclaren Medicaid |
$10,088.75
|
| Rate for Payer: Meridian Medicaid |
$10,593.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,088.75
|
| Rate for Payer: UHC Medicaid |
$10,088.75
|
| Rate for Payer: UHCCP Medicaid |
$10,088.75
|
|
|
MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES
|
Facility
|
IP
|
$20,567.13
|
|
|
Service Code
|
APR-DRG 2603
|
| Min. Negotiated Rate |
$19,587.74 |
| Max. Negotiated Rate |
$20,567.13 |
| Rate for Payer: BCBS Complete |
$20,567.13
|
| Rate for Payer: Mclaren Medicaid |
$19,587.74
|
| Rate for Payer: Meridian Medicaid |
$20,567.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,587.74
|
| Rate for Payer: UHC Medicaid |
$19,587.74
|
| Rate for Payer: UHCCP Medicaid |
$19,587.74
|
|
|
MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES
|
Facility
|
IP
|
$24,451.50
|
|
|
Service Code
|
APR-DRG 2604
|
| Min. Negotiated Rate |
$23,287.14 |
| Max. Negotiated Rate |
$24,451.50 |
| Rate for Payer: BCBS Complete |
$24,451.50
|
| Rate for Payer: Mclaren Medicaid |
$23,287.14
|
| Rate for Payer: Meridian Medicaid |
$24,451.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,287.14
|
| Rate for Payer: UHC Medicaid |
$23,287.14
|
| Rate for Payer: UHCCP Medicaid |
$23,287.14
|
|
|
MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES
|
Facility
|
IP
|
$14,029.01
|
|
|
Service Code
|
APR-DRG 2602
|
| Min. Negotiated Rate |
$13,360.96 |
| Max. Negotiated Rate |
$14,029.01 |
| Rate for Payer: BCBS Complete |
$14,029.01
|
| Rate for Payer: Mclaren Medicaid |
$13,360.96
|
| Rate for Payer: Meridian Medicaid |
$14,029.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,360.96
|
| Rate for Payer: UHC Medicaid |
$13,360.96
|
| Rate for Payer: UHCCP Medicaid |
$13,360.96
|
|
|
MAJOR RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$11,877.08
|
|
|
Service Code
|
APR-DRG 1201
|
| Min. Negotiated Rate |
$11,311.51 |
| Max. Negotiated Rate |
$11,877.08 |
| Rate for Payer: BCBS Complete |
$11,877.08
|
| Rate for Payer: Mclaren Medicaid |
$11,311.51
|
| Rate for Payer: Meridian Medicaid |
$11,877.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,311.51
|
| Rate for Payer: UHC Medicaid |
$11,311.51
|
| Rate for Payer: UHCCP Medicaid |
$11,311.51
|
|
|
MAJOR RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$35,166.96
|
|
|
Service Code
|
APR-DRG 1204
|
| Min. Negotiated Rate |
$33,492.34 |
| Max. Negotiated Rate |
$35,166.96 |
| Rate for Payer: BCBS Complete |
$35,166.96
|
| Rate for Payer: Mclaren Medicaid |
$33,492.34
|
| Rate for Payer: Meridian Medicaid |
$35,166.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$33,492.34
|
| Rate for Payer: UHC Medicaid |
$33,492.34
|
| Rate for Payer: UHCCP Medicaid |
$33,492.34
|
|
|
MAJOR RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$22,440.61
|
|
|
Service Code
|
APR-DRG 1203
|
| Min. Negotiated Rate |
$21,372.01 |
| Max. Negotiated Rate |
$22,440.61 |
| Rate for Payer: BCBS Complete |
$22,440.61
|
| Rate for Payer: Mclaren Medicaid |
$21,372.01
|
| Rate for Payer: Meridian Medicaid |
$22,440.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,372.01
|
| Rate for Payer: UHC Medicaid |
$21,372.01
|
| Rate for Payer: UHCCP Medicaid |
$21,372.01
|
|
|
MAJOR RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$16,006.00
|
|
|
Service Code
|
APR-DRG 1202
|
| Min. Negotiated Rate |
$15,243.81 |
| Max. Negotiated Rate |
$16,006.00 |
| Rate for Payer: BCBS Complete |
$16,006.00
|
| Rate for Payer: Mclaren Medicaid |
$15,243.81
|
| Rate for Payer: Meridian Medicaid |
$16,006.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,243.81
|
| Rate for Payer: UHC Medicaid |
$15,243.81
|
| Rate for Payer: UHCCP Medicaid |
$15,243.81
|
|
|
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS
|
Facility
|
IP
|
$11,789.92
|
|
|
Service Code
|
APR-DRG 1374
|
| Min. Negotiated Rate |
$11,228.49 |
| Max. Negotiated Rate |
$11,789.92 |
| Rate for Payer: BCBS Complete |
$11,789.92
|
| Rate for Payer: Mclaren Medicaid |
$11,228.49
|
| Rate for Payer: Meridian Medicaid |
$11,789.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,228.49
|
| Rate for Payer: UHC Medicaid |
$11,228.49
|
| Rate for Payer: UHCCP Medicaid |
$11,228.49
|
|
|
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS
|
Facility
|
IP
|
$6,546.59
|
|
|
Service Code
|
APR-DRG 1373
|
| Min. Negotiated Rate |
$6,234.85 |
| Max. Negotiated Rate |
$6,546.59 |
| Rate for Payer: BCBS Complete |
$6,546.59
|
| Rate for Payer: Mclaren Medicaid |
$6,234.85
|
| Rate for Payer: Meridian Medicaid |
$6,546.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,234.85
|
| Rate for Payer: UHC Medicaid |
$6,234.85
|
| Rate for Payer: UHCCP Medicaid |
$6,234.85
|
|
|
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS
|
Facility
|
IP
|
$2,615.61
|
|
|
Service Code
|
APR-DRG 1371
|
| Min. Negotiated Rate |
$2,491.06 |
| Max. Negotiated Rate |
$2,615.61 |
| Rate for Payer: BCBS Complete |
$2,615.61
|
| Rate for Payer: Mclaren Medicaid |
$2,491.06
|
| Rate for Payer: Meridian Medicaid |
$2,615.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,491.06
|
| Rate for Payer: UHC Medicaid |
$2,491.06
|
| Rate for Payer: UHCCP Medicaid |
$2,491.06
|
|
|
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS
|
Facility
|
IP
|
$4,365.00
|
|
|
Service Code
|
APR-DRG 1372
|
| Min. Negotiated Rate |
$4,157.14 |
| Max. Negotiated Rate |
$4,365.00 |
| Rate for Payer: BCBS Complete |
$4,365.00
|
| Rate for Payer: Mclaren Medicaid |
$4,157.14
|
| Rate for Payer: Meridian Medicaid |
$4,365.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,157.14
|
| Rate for Payer: UHC Medicaid |
$4,157.14
|
| Rate for Payer: UHCCP Medicaid |
$4,157.14
|
|
|
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$29,444.32
|
|
|
Service Code
|
MSDRG 507
|
| Min. Negotiated Rate |
$14,914.37 |
| Max. Negotiated Rate |
$29,444.32 |
| Rate for Payer: Aetna Medicare |
$16,327.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,624.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,624.17
|
| Rate for Payer: BCBS MAPPO |
$15,699.34
|
| Rate for Payer: BCBS Trust/PPO |
$25,469.04
|
| Rate for Payer: BCN Commercial |
$25,469.04
|
| Rate for Payer: BCN Medicare Advantage |
$15,699.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,699.34
|
| Rate for Payer: Mclaren Medicare |
$15,699.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,484.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,054.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,269.27
|
| Rate for Payer: Nomi Health Commercial |
$23,302.56
|
| Rate for Payer: PACE Medicare |
$14,914.37
|
| Rate for Payer: PACE SWMI |
$15,699.34
|
| Rate for Payer: PHP Medicare Advantage |
$15,699.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29,123.03
|
| Rate for Payer: Priority Health Medicare |
$15,699.34
|
| Rate for Payer: Priority Health Tiered Network |
$23,298.42
|
| Rate for Payer: Railroad Medicare Medicare |
$15,699.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,444.32
|
| Rate for Payer: UHC Core |
$24,633.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,699.34
|
| Rate for Payer: UHC Exchange |
$20,117.88
|
| Rate for Payer: VA VA |
$15,699.34
|
|
|
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,684.72
|
|
|
Service Code
|
MSDRG 508
|
| Min. Negotiated Rate |
$12,594.56 |
| Max. Negotiated Rate |
$24,684.72 |
| Rate for Payer: Aetna Medicare |
$13,787.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,571.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,571.79
|
| Rate for Payer: BCBS MAPPO |
$13,257.43
|
| Rate for Payer: BCBS Trust/PPO |
$17,132.17
|
| Rate for Payer: BCN Commercial |
$17,132.17
|
| Rate for Payer: BCN Medicare Advantage |
$13,257.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,257.43
|
| Rate for Payer: Mclaren Medicare |
$13,257.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,920.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,246.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,583.17
|
| Rate for Payer: Nomi Health Commercial |
$19,535.76
|
| Rate for Payer: PACE Medicare |
$12,594.56
|
| Rate for Payer: PACE SWMI |
$13,257.43
|
| Rate for Payer: PHP Medicare Advantage |
$13,257.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,415.37
|
| Rate for Payer: Priority Health Medicare |
$13,257.43
|
| Rate for Payer: Priority Health Tiered Network |
$19,532.29
|
| Rate for Payer: Railroad Medicare Medicare |
$13,257.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,684.72
|
| Rate for Payer: UHC Core |
$20,651.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,257.43
|
| Rate for Payer: UHC Exchange |
$16,865.87
|
| Rate for Payer: VA VA |
$13,257.43
|
|
|
MAJOR SKIN DISORDERS
|
Facility
|
IP
|
$10,239.07
|
|
|
Service Code
|
APR-DRG 3813
|
| Min. Negotiated Rate |
$9,751.50 |
| Max. Negotiated Rate |
$10,239.07 |
| Rate for Payer: BCBS Complete |
$10,239.07
|
| Rate for Payer: Mclaren Medicaid |
$9,751.50
|
| Rate for Payer: Meridian Medicaid |
$10,239.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,751.50
|
| Rate for Payer: UHC Medicaid |
$9,751.50
|
| Rate for Payer: UHCCP Medicaid |
$9,751.50
|
|
|
MAJOR SKIN DISORDERS
|
Facility
|
IP
|
$2,703.99
|
|
|
Service Code
|
APR-DRG 3811
|
| Min. Negotiated Rate |
$2,575.23 |
| Max. Negotiated Rate |
$2,703.99 |
| Rate for Payer: BCBS Complete |
$2,703.99
|
| Rate for Payer: Mclaren Medicaid |
$2,575.23
|
| Rate for Payer: Meridian Medicaid |
$2,703.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,575.23
|
| Rate for Payer: UHC Medicaid |
$2,575.23
|
| Rate for Payer: UHCCP Medicaid |
$2,575.23
|
|
|
MAJOR SKIN DISORDERS
|
Facility
|
IP
|
$6,312.33
|
|
|
Service Code
|
APR-DRG 3812
|
| Min. Negotiated Rate |
$6,011.74 |
| Max. Negotiated Rate |
$6,312.33 |
| Rate for Payer: BCBS Complete |
$6,312.33
|
| Rate for Payer: Mclaren Medicaid |
$6,011.74
|
| Rate for Payer: Meridian Medicaid |
$6,312.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,011.74
|
| Rate for Payer: UHC Medicaid |
$6,011.74
|
| Rate for Payer: UHCCP Medicaid |
$6,011.74
|
|