|
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$99,227.90
|
|
|
Service Code
|
APR-DRG 6024
|
| Min. Negotiated Rate |
$94,502.76 |
| Max. Negotiated Rate |
$99,227.90 |
| Rate for Payer: BCBS Complete |
$99,227.90
|
| Rate for Payer: Mclaren Medicaid |
$94,502.76
|
| Rate for Payer: Meridian Medicaid |
$99,227.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$94,502.76
|
| Rate for Payer: UHC Medicaid |
$94,502.76
|
| Rate for Payer: UHCCP Medicaid |
$94,502.76
|
|
|
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$42,737.16
|
|
|
Service Code
|
APR-DRG 6021
|
| Min. Negotiated Rate |
$40,702.05 |
| Max. Negotiated Rate |
$42,737.16 |
| Rate for Payer: BCBS Complete |
$42,737.16
|
| Rate for Payer: Mclaren Medicaid |
$40,702.05
|
| Rate for Payer: Meridian Medicaid |
$42,737.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$40,702.05
|
| Rate for Payer: UHC Medicaid |
$40,702.05
|
| Rate for Payer: UHCCP Medicaid |
$40,702.05
|
|
|
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$76,088.14
|
|
|
Service Code
|
APR-DRG 6022
|
| Min. Negotiated Rate |
$72,464.90 |
| Max. Negotiated Rate |
$76,088.14 |
| Rate for Payer: BCBS Complete |
$76,088.14
|
| Rate for Payer: Mclaren Medicaid |
$72,464.90
|
| Rate for Payer: Meridian Medicaid |
$76,088.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$72,464.90
|
| Rate for Payer: UHC Medicaid |
$72,464.90
|
| Rate for Payer: UHCCP Medicaid |
$72,464.90
|
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION
|
Facility
|
IP
|
$17,364.35
|
|
|
Service Code
|
APR-DRG 6081
|
| Min. Negotiated Rate |
$16,537.48 |
| Max. Negotiated Rate |
$17,364.35 |
| Rate for Payer: BCBS Complete |
$17,364.35
|
| Rate for Payer: Mclaren Medicaid |
$16,537.48
|
| Rate for Payer: Meridian Medicaid |
$17,364.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,537.48
|
| Rate for Payer: UHC Medicaid |
$16,537.48
|
| Rate for Payer: UHCCP Medicaid |
$16,537.48
|
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION
|
Facility
|
IP
|
$42,136.67
|
|
|
Service Code
|
APR-DRG 6084
|
| Min. Negotiated Rate |
$40,130.17 |
| Max. Negotiated Rate |
$42,136.67 |
| Rate for Payer: BCBS Complete |
$42,136.67
|
| Rate for Payer: Mclaren Medicaid |
$40,130.17
|
| Rate for Payer: Meridian Medicaid |
$42,136.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$40,130.17
|
| Rate for Payer: UHC Medicaid |
$40,130.17
|
| Rate for Payer: UHCCP Medicaid |
$40,130.17
|
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION
|
Facility
|
IP
|
$20,076.21
|
|
|
Service Code
|
APR-DRG 6082
|
| Min. Negotiated Rate |
$19,120.20 |
| Max. Negotiated Rate |
$20,076.21 |
| Rate for Payer: BCBS Complete |
$20,076.21
|
| Rate for Payer: Mclaren Medicaid |
$19,120.20
|
| Rate for Payer: Meridian Medicaid |
$20,076.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,120.20
|
| Rate for Payer: UHC Medicaid |
$19,120.20
|
| Rate for Payer: UHCCP Medicaid |
$19,120.20
|
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION
|
Facility
|
IP
|
$36,139.72
|
|
|
Service Code
|
APR-DRG 6083
|
| Min. Negotiated Rate |
$34,418.78 |
| Max. Negotiated Rate |
$36,139.72 |
| Rate for Payer: BCBS Complete |
$36,139.72
|
| Rate for Payer: Mclaren Medicaid |
$34,418.78
|
| Rate for Payer: Meridian Medicaid |
$36,139.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$34,418.78
|
| Rate for Payer: UHC Medicaid |
$34,418.78
|
| Rate for Payer: UHCCP Medicaid |
$34,418.78
|
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$44,541.02
|
|
|
Service Code
|
APR-DRG 6072
|
| Min. Negotiated Rate |
$42,420.02 |
| Max. Negotiated Rate |
$44,541.02 |
| Rate for Payer: BCBS Complete |
$44,541.02
|
| Rate for Payer: Mclaren Medicaid |
$42,420.02
|
| Rate for Payer: Meridian Medicaid |
$44,541.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$42,420.02
|
| Rate for Payer: UHC Medicaid |
$42,420.02
|
| Rate for Payer: UHCCP Medicaid |
$42,420.02
|
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$55,299.47
|
|
|
Service Code
|
APR-DRG 6073
|
| Min. Negotiated Rate |
$52,666.16 |
| Max. Negotiated Rate |
$55,299.47 |
| Rate for Payer: BCBS Complete |
$55,299.47
|
| Rate for Payer: Mclaren Medicaid |
$52,666.16
|
| Rate for Payer: Meridian Medicaid |
$55,299.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$52,666.16
|
| Rate for Payer: UHC Medicaid |
$52,666.16
|
| Rate for Payer: UHCCP Medicaid |
$52,666.16
|
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$27,620.98
|
|
|
Service Code
|
APR-DRG 6071
|
| Min. Negotiated Rate |
$26,305.69 |
| Max. Negotiated Rate |
$27,620.98 |
| Rate for Payer: BCBS Complete |
$27,620.98
|
| Rate for Payer: Mclaren Medicaid |
$26,305.69
|
| Rate for Payer: Meridian Medicaid |
$27,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,305.69
|
| Rate for Payer: UHC Medicaid |
$26,305.69
|
| Rate for Payer: UHCCP Medicaid |
$26,305.69
|
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$69,994.94
|
|
|
Service Code
|
APR-DRG 6074
|
| Min. Negotiated Rate |
$66,661.85 |
| Max. Negotiated Rate |
$69,994.94 |
| Rate for Payer: BCBS Complete |
$69,994.94
|
| Rate for Payer: Mclaren Medicaid |
$66,661.85
|
| Rate for Payer: Meridian Medicaid |
$69,994.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$66,661.85
|
| Rate for Payer: UHC Medicaid |
$66,661.85
|
| Rate for Payer: UHCCP Medicaid |
$66,661.85
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$50,304.93
|
|
|
Service Code
|
APR-DRG 6133
|
| Min. Negotiated Rate |
$47,909.46 |
| Max. Negotiated Rate |
$50,304.93 |
| Rate for Payer: BCBS Complete |
$50,304.93
|
| Rate for Payer: Mclaren Medicaid |
$47,909.46
|
| Rate for Payer: Meridian Medicaid |
$50,304.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$47,909.46
|
| Rate for Payer: UHC Medicaid |
$47,909.46
|
| Rate for Payer: UHCCP Medicaid |
$47,909.46
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$93,190.99
|
|
|
Service Code
|
APR-DRG 6134
|
| Min. Negotiated Rate |
$88,753.33 |
| Max. Negotiated Rate |
$93,190.99 |
| Rate for Payer: BCBS Complete |
$93,190.99
|
| Rate for Payer: Mclaren Medicaid |
$88,753.33
|
| Rate for Payer: Meridian Medicaid |
$93,190.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$88,753.33
|
| Rate for Payer: UHC Medicaid |
$88,753.33
|
| Rate for Payer: UHCCP Medicaid |
$88,753.33
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$33,443.60
|
|
|
Service Code
|
APR-DRG 6132
|
| Min. Negotiated Rate |
$31,851.05 |
| Max. Negotiated Rate |
$33,443.60 |
| Rate for Payer: BCBS Complete |
$33,443.60
|
| Rate for Payer: Mclaren Medicaid |
$31,851.05
|
| Rate for Payer: Meridian Medicaid |
$33,443.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$31,851.05
|
| Rate for Payer: UHC Medicaid |
$31,851.05
|
| Rate for Payer: UHCCP Medicaid |
$31,851.05
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$10,870.43
|
|
|
Service Code
|
APR-DRG 6131
|
| Min. Negotiated Rate |
$10,352.79 |
| Max. Negotiated Rate |
$10,870.43 |
| Rate for Payer: BCBS Complete |
$10,870.43
|
| Rate for Payer: Mclaren Medicaid |
$10,352.79
|
| Rate for Payer: Meridian Medicaid |
$10,870.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,352.79
|
| Rate for Payer: UHC Medicaid |
$10,352.79
|
| Rate for Payer: UHCCP Medicaid |
$10,352.79
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$33,495.05
|
|
|
Service Code
|
APR-DRG 6113
|
| Min. Negotiated Rate |
$31,900.05 |
| Max. Negotiated Rate |
$33,495.05 |
| Rate for Payer: BCBS Complete |
$33,495.05
|
| Rate for Payer: Mclaren Medicaid |
$31,900.05
|
| Rate for Payer: Meridian Medicaid |
$33,495.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$31,900.05
|
| Rate for Payer: UHC Medicaid |
$31,900.05
|
| Rate for Payer: UHCCP Medicaid |
$31,900.05
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$12,542.94
|
|
|
Service Code
|
APR-DRG 6111
|
| Min. Negotiated Rate |
$11,945.66 |
| Max. Negotiated Rate |
$12,542.94 |
| Rate for Payer: BCBS Complete |
$12,542.94
|
| Rate for Payer: Mclaren Medicaid |
$11,945.66
|
| Rate for Payer: Meridian Medicaid |
$12,542.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,945.66
|
| Rate for Payer: UHC Medicaid |
$11,945.66
|
| Rate for Payer: UHCCP Medicaid |
$11,945.66
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$84,812.09
|
|
|
Service Code
|
APR-DRG 6114
|
| Min. Negotiated Rate |
$80,773.41 |
| Max. Negotiated Rate |
$84,812.09 |
| Rate for Payer: BCBS Complete |
$84,812.09
|
| Rate for Payer: Mclaren Medicaid |
$80,773.41
|
| Rate for Payer: Meridian Medicaid |
$84,812.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$80,773.41
|
| Rate for Payer: UHC Medicaid |
$80,773.41
|
| Rate for Payer: UHCCP Medicaid |
$80,773.41
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$22,746.90
|
|
|
Service Code
|
APR-DRG 6112
|
| Min. Negotiated Rate |
$21,663.72 |
| Max. Negotiated Rate |
$22,746.90 |
| Rate for Payer: BCBS Complete |
$22,746.90
|
| Rate for Payer: Mclaren Medicaid |
$21,663.72
|
| Rate for Payer: Meridian Medicaid |
$22,746.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,663.72
|
| Rate for Payer: UHC Medicaid |
$21,663.72
|
| Rate for Payer: UHCCP Medicaid |
$21,663.72
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$19,050.18
|
|
|
Service Code
|
APR-DRG 6142
|
| Min. Negotiated Rate |
$18,143.03 |
| Max. Negotiated Rate |
$19,050.18 |
| Rate for Payer: BCBS Complete |
$19,050.18
|
| Rate for Payer: Mclaren Medicaid |
$18,143.03
|
| Rate for Payer: Meridian Medicaid |
$19,050.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,143.03
|
| Rate for Payer: UHC Medicaid |
$18,143.03
|
| Rate for Payer: UHCCP Medicaid |
$18,143.03
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$11,937.01
|
|
|
Service Code
|
APR-DRG 6141
|
| Min. Negotiated Rate |
$11,368.58 |
| Max. Negotiated Rate |
$11,937.01 |
| Rate for Payer: BCBS Complete |
$11,937.01
|
| Rate for Payer: Mclaren Medicaid |
$11,368.58
|
| Rate for Payer: Meridian Medicaid |
$11,937.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,368.58
|
| Rate for Payer: UHC Medicaid |
$11,368.58
|
| Rate for Payer: UHCCP Medicaid |
$11,368.58
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$26,150.65
|
|
|
Service Code
|
APR-DRG 6143
|
| Min. Negotiated Rate |
$24,905.38 |
| Max. Negotiated Rate |
$26,150.65 |
| Rate for Payer: BCBS Complete |
$26,150.65
|
| Rate for Payer: Mclaren Medicaid |
$24,905.38
|
| Rate for Payer: Meridian Medicaid |
$26,150.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$24,905.38
|
| Rate for Payer: UHC Medicaid |
$24,905.38
|
| Rate for Payer: UHCCP Medicaid |
$24,905.38
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$42,970.21
|
|
|
Service Code
|
APR-DRG 6144
|
| Min. Negotiated Rate |
$40,924.01 |
| Max. Negotiated Rate |
$42,970.21 |
| Rate for Payer: BCBS Complete |
$42,970.21
|
| Rate for Payer: Mclaren Medicaid |
$40,924.01
|
| Rate for Payer: Meridian Medicaid |
$42,970.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$40,924.01
|
| Rate for Payer: UHC Medicaid |
$40,924.01
|
| Rate for Payer: UHCCP Medicaid |
$40,924.01
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$26,374.01
|
|
|
Service Code
|
APR-DRG 6122
|
| Min. Negotiated Rate |
$25,118.10 |
| Max. Negotiated Rate |
$26,374.01 |
| Rate for Payer: BCBS Complete |
$26,374.01
|
| Rate for Payer: Mclaren Medicaid |
$25,118.10
|
| Rate for Payer: Meridian Medicaid |
$26,374.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,118.10
|
| Rate for Payer: UHC Medicaid |
$25,118.10
|
| Rate for Payer: UHCCP Medicaid |
$25,118.10
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$76,953.76
|
|
|
Service Code
|
APR-DRG 6124
|
| Min. Negotiated Rate |
$73,289.29 |
| Max. Negotiated Rate |
$76,953.76 |
| Rate for Payer: BCBS Complete |
$76,953.76
|
| Rate for Payer: Mclaren Medicaid |
$73,289.29
|
| Rate for Payer: Meridian Medicaid |
$76,953.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$73,289.29
|
| Rate for Payer: UHC Medicaid |
$73,289.29
|
| Rate for Payer: UHCCP Medicaid |
$73,289.29
|
|