|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$11,375.35
|
|
|
Service Code
|
MSDRG 433
|
| Min. Negotiated Rate |
$8,645.27 |
| Max. Negotiated Rate |
$11,375.35 |
| Rate for Payer: Aetna Medicare |
$9,464.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,375.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,375.35
|
| Rate for Payer: BCBS MAPPO |
$9,100.28
|
| Rate for Payer: BCN Medicare Advantage |
$9,100.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,100.28
|
| Rate for Payer: Mclaren Medicare |
$9,100.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,555.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,465.32
|
| Rate for Payer: PACE Medicare |
$8,645.27
|
| Rate for Payer: PACE SWMI |
$9,100.28
|
| Rate for Payer: PHP Medicare Advantage |
$9,100.28
|
| Rate for Payer: Priority Health Medicare |
$9,100.28
|
| Rate for Payer: Railroad Medicare Medicare |
$9,100.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,100.28
|
| Rate for Payer: UHC Medicare Advantage |
$9,100.28
|
| Rate for Payer: VA VA |
$9,100.28
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$20,373.54
|
|
|
Service Code
|
MSDRG 432
|
| Min. Negotiated Rate |
$15,483.89 |
| Max. Negotiated Rate |
$20,373.54 |
| Rate for Payer: Aetna Medicare |
$16,950.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,373.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,373.54
|
| Rate for Payer: BCBS MAPPO |
$16,298.83
|
| Rate for Payer: BCN Medicare Advantage |
$16,298.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,298.83
|
| Rate for Payer: Mclaren Medicare |
$16,298.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,113.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,743.65
|
| Rate for Payer: PACE Medicare |
$15,483.89
|
| Rate for Payer: PACE SWMI |
$16,298.83
|
| Rate for Payer: PHP Medicare Advantage |
$16,298.83
|
| Rate for Payer: Priority Health Medicare |
$16,298.83
|
| Rate for Payer: Railroad Medicare Medicare |
$16,298.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,298.83
|
| Rate for Payer: UHC Medicare Advantage |
$16,298.83
|
| Rate for Payer: VA VA |
$16,298.83
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$7,598.23
|
|
|
Service Code
|
MSDRG 434
|
| Min. Negotiated Rate |
$5,774.65 |
| Max. Negotiated Rate |
$7,598.23 |
| Rate for Payer: Aetna Medicare |
$6,321.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,598.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,598.23
|
| Rate for Payer: BCBS MAPPO |
$6,078.58
|
| Rate for Payer: BCN Medicare Advantage |
$6,078.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,078.58
|
| Rate for Payer: Mclaren Medicare |
$6,078.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,382.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,990.37
|
| Rate for Payer: PACE Medicare |
$5,774.65
|
| Rate for Payer: PACE SWMI |
$6,078.58
|
| Rate for Payer: PHP Medicare Advantage |
$6,078.58
|
| Rate for Payer: Priority Health Medicare |
$6,078.58
|
| Rate for Payer: Railroad Medicare Medicare |
$6,078.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,078.58
|
| Rate for Payer: UHC Medicare Advantage |
$6,078.58
|
| Rate for Payer: VA VA |
$6,078.58
|
|
|
MS-DRG 42.00: COAGULATION DISORDERS
|
Facility
|
IP
|
$16,213.90
|
|
|
Service Code
|
MSDRG 813
|
| Min. Negotiated Rate |
$12,322.56 |
| Max. Negotiated Rate |
$16,213.90 |
| Rate for Payer: Aetna Medicare |
$13,489.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,213.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,213.90
|
| Rate for Payer: BCBS MAPPO |
$12,971.12
|
| Rate for Payer: BCN Medicare Advantage |
$12,971.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,971.12
|
| Rate for Payer: Mclaren Medicare |
$12,971.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,619.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,916.79
|
| Rate for Payer: PACE Medicare |
$12,322.56
|
| Rate for Payer: PACE SWMI |
$12,971.12
|
| Rate for Payer: PHP Medicare Advantage |
$12,971.12
|
| Rate for Payer: Priority Health Medicare |
$12,971.12
|
| Rate for Payer: Railroad Medicare Medicare |
$12,971.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,971.12
|
| Rate for Payer: UHC Medicare Advantage |
$12,971.12
|
| Rate for Payer: VA VA |
$12,971.12
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$84,943.15
|
|
|
Service Code
|
MSDRG 429
|
| Min. Negotiated Rate |
$64,556.79 |
| Max. Negotiated Rate |
$84,943.15 |
| Rate for Payer: Aetna Medicare |
$70,672.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84,943.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84,943.15
|
| Rate for Payer: BCBS MAPPO |
$67,954.52
|
| Rate for Payer: BCN Medicare Advantage |
$67,954.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67,954.52
|
| Rate for Payer: Mclaren Medicare |
$67,954.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71,352.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78,147.70
|
| Rate for Payer: PACE Medicare |
$64,556.79
|
| Rate for Payer: PACE SWMI |
$67,954.52
|
| Rate for Payer: PHP Medicare Advantage |
$67,954.52
|
| Rate for Payer: Priority Health Medicare |
$67,954.52
|
| Rate for Payer: Railroad Medicare Medicare |
$67,954.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$67,954.52
|
| Rate for Payer: UHC Medicare Advantage |
$67,954.52
|
| Rate for Payer: VA VA |
$67,954.52
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC
|
Facility
|
IP
|
$55,902.74
|
|
|
Service Code
|
MSDRG 430
|
| Min. Negotiated Rate |
$42,486.08 |
| Max. Negotiated Rate |
$55,902.74 |
| Rate for Payer: Aetna Medicare |
$46,511.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55,902.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55,902.74
|
| Rate for Payer: BCBS MAPPO |
$44,722.19
|
| Rate for Payer: BCN Medicare Advantage |
$44,722.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44,722.19
|
| Rate for Payer: Mclaren Medicare |
$44,722.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46,958.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51,430.52
|
| Rate for Payer: PACE Medicare |
$42,486.08
|
| Rate for Payer: PACE SWMI |
$44,722.19
|
| Rate for Payer: PHP Medicare Advantage |
$44,722.19
|
| Rate for Payer: Priority Health Medicare |
$44,722.19
|
| Rate for Payer: Railroad Medicare Medicare |
$44,722.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$44,722.19
|
| Rate for Payer: UHC Medicare Advantage |
$44,722.19
|
| Rate for Payer: VA VA |
$44,722.19
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC
|
Facility
|
IP
|
$11,570.64
|
|
|
Service Code
|
MSDRG 381
|
| Min. Negotiated Rate |
$8,793.68 |
| Max. Negotiated Rate |
$11,570.64 |
| Rate for Payer: Aetna Medicare |
$9,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,570.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,570.64
|
| Rate for Payer: BCBS MAPPO |
$9,256.51
|
| Rate for Payer: BCN Medicare Advantage |
$9,256.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,256.51
|
| Rate for Payer: Mclaren Medicare |
$9,256.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,719.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,644.99
|
| Rate for Payer: PACE Medicare |
$8,793.68
|
| Rate for Payer: PACE SWMI |
$9,256.51
|
| Rate for Payer: PHP Medicare Advantage |
$9,256.51
|
| Rate for Payer: Priority Health Medicare |
$9,256.51
|
| Rate for Payer: Railroad Medicare Medicare |
$9,256.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,256.51
|
| Rate for Payer: UHC Medicare Advantage |
$9,256.51
|
| Rate for Payer: VA VA |
$9,256.51
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$20,021.41
|
|
|
Service Code
|
MSDRG 380
|
| Min. Negotiated Rate |
$15,216.27 |
| Max. Negotiated Rate |
$20,021.41 |
| Rate for Payer: Aetna Medicare |
$16,657.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,021.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,021.41
|
| Rate for Payer: BCBS MAPPO |
$16,017.13
|
| Rate for Payer: BCN Medicare Advantage |
$16,017.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,017.13
|
| Rate for Payer: Mclaren Medicare |
$16,017.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,817.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,419.70
|
| Rate for Payer: PACE Medicare |
$15,216.27
|
| Rate for Payer: PACE SWMI |
$16,017.13
|
| Rate for Payer: PHP Medicare Advantage |
$16,017.13
|
| Rate for Payer: Priority Health Medicare |
$16,017.13
|
| Rate for Payer: Railroad Medicare Medicare |
$16,017.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,017.13
|
| Rate for Payer: UHC Medicare Advantage |
$16,017.13
|
| Rate for Payer: VA VA |
$16,017.13
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC
|
Facility
|
IP
|
$8,132.46
|
|
|
Service Code
|
MSDRG 382
|
| Min. Negotiated Rate |
$6,180.67 |
| Max. Negotiated Rate |
$8,132.46 |
| Rate for Payer: Aetna Medicare |
$6,766.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,132.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,132.46
|
| Rate for Payer: BCBS MAPPO |
$6,505.97
|
| Rate for Payer: BCN Medicare Advantage |
$6,505.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,505.97
|
| Rate for Payer: Mclaren Medicare |
$6,505.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,831.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,481.87
|
| Rate for Payer: PACE Medicare |
$6,180.67
|
| Rate for Payer: PACE SWMI |
$6,505.97
|
| Rate for Payer: PHP Medicare Advantage |
$6,505.97
|
| Rate for Payer: Priority Health Medicare |
$6,505.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6,505.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,505.97
|
| Rate for Payer: UHC Medicare Advantage |
$6,505.97
|
| Rate for Payer: VA VA |
$6,505.97
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC
|
Facility
|
IP
|
$10,829.99
|
|
|
Service Code
|
MSDRG 920
|
| Min. Negotiated Rate |
$8,230.79 |
| Max. Negotiated Rate |
$10,829.99 |
| Rate for Payer: Aetna Medicare |
$9,010.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,829.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,829.99
|
| Rate for Payer: BCBS MAPPO |
$8,663.99
|
| Rate for Payer: BCN Medicare Advantage |
$8,663.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,663.99
|
| Rate for Payer: Mclaren Medicare |
$8,663.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,097.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,963.59
|
| Rate for Payer: PACE Medicare |
$8,230.79
|
| Rate for Payer: PACE SWMI |
$8,663.99
|
| Rate for Payer: PHP Medicare Advantage |
$8,663.99
|
| Rate for Payer: Priority Health Medicare |
$8,663.99
|
| Rate for Payer: Railroad Medicare Medicare |
$8,663.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,663.99
|
| Rate for Payer: UHC Medicare Advantage |
$8,663.99
|
| Rate for Payer: VA VA |
$8,663.99
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC
|
Facility
|
IP
|
$19,002.50
|
|
|
Service Code
|
MSDRG 919
|
| Min. Negotiated Rate |
$14,441.90 |
| Max. Negotiated Rate |
$19,002.50 |
| Rate for Payer: Aetna Medicare |
$15,810.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,002.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,002.50
|
| Rate for Payer: BCBS MAPPO |
$15,202.00
|
| Rate for Payer: BCN Medicare Advantage |
$15,202.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,202.00
|
| Rate for Payer: Mclaren Medicare |
$15,202.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,962.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,482.30
|
| Rate for Payer: PACE Medicare |
$14,441.90
|
| Rate for Payer: PACE SWMI |
$15,202.00
|
| Rate for Payer: PHP Medicare Advantage |
$15,202.00
|
| Rate for Payer: Priority Health Medicare |
$15,202.00
|
| Rate for Payer: Railroad Medicare Medicare |
$15,202.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,202.00
|
| Rate for Payer: UHC Medicare Advantage |
$15,202.00
|
| Rate for Payer: VA VA |
$15,202.00
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$7,509.20
|
|
|
Service Code
|
MSDRG 921
|
| Min. Negotiated Rate |
$5,706.99 |
| Max. Negotiated Rate |
$7,509.20 |
| Rate for Payer: Aetna Medicare |
$6,247.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,509.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,509.20
|
| Rate for Payer: BCBS MAPPO |
$6,007.36
|
| Rate for Payer: BCN Medicare Advantage |
$6,007.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,007.36
|
| Rate for Payer: Mclaren Medicare |
$6,007.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,307.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,908.46
|
| Rate for Payer: PACE Medicare |
$5,706.99
|
| Rate for Payer: PACE SWMI |
$6,007.36
|
| Rate for Payer: PHP Medicare Advantage |
$6,007.36
|
| Rate for Payer: Priority Health Medicare |
$6,007.36
|
| Rate for Payer: Railroad Medicare Medicare |
$6,007.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,007.36
|
| Rate for Payer: UHC Medicare Advantage |
$6,007.36
|
| Rate for Payer: VA VA |
$6,007.36
|
|
|
MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES
|
Facility
|
IP
|
$110,778.06
|
|
|
Service Code
|
MSDRG 212
|
| Min. Negotiated Rate |
$84,191.33 |
| Max. Negotiated Rate |
$110,778.06 |
| Rate for Payer: Aetna Medicare |
$92,167.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110,778.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110,778.06
|
| Rate for Payer: BCBS MAPPO |
$88,622.45
|
| Rate for Payer: BCN Medicare Advantage |
$88,622.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88,622.45
|
| Rate for Payer: Mclaren Medicare |
$88,622.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93,053.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101,915.82
|
| Rate for Payer: PACE Medicare |
$84,191.33
|
| Rate for Payer: PACE SWMI |
$88,622.45
|
| Rate for Payer: PHP Medicare Advantage |
$88,622.45
|
| Rate for Payer: Priority Health Medicare |
$88,622.45
|
| Rate for Payer: Railroad Medicare Medicare |
$88,622.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$88,622.45
|
| Rate for Payer: UHC Medicare Advantage |
$88,622.45
|
| Rate for Payer: VA VA |
$88,622.45
|
|
|
MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION
|
Facility
|
IP
|
$63,146.41
|
|
|
Service Code
|
MSDRG 317
|
| Min. Negotiated Rate |
$47,991.27 |
| Max. Negotiated Rate |
$63,146.41 |
| Rate for Payer: Aetna Medicare |
$52,537.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63,146.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63,146.41
|
| Rate for Payer: BCBS MAPPO |
$50,517.13
|
| Rate for Payer: BCN Medicare Advantage |
$50,517.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50,517.13
|
| Rate for Payer: Mclaren Medicare |
$50,517.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53,042.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58,094.70
|
| Rate for Payer: PACE Medicare |
$47,991.27
|
| Rate for Payer: PACE SWMI |
$50,517.13
|
| Rate for Payer: PHP Medicare Advantage |
$50,517.13
|
| Rate for Payer: Priority Health Medicare |
$50,517.13
|
| Rate for Payer: Railroad Medicare Medicare |
$50,517.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$50,517.13
|
| Rate for Payer: UHC Medicare Advantage |
$50,517.13
|
| Rate for Payer: VA VA |
$50,517.13
|
|
|
MS-DRG 42.00: CONCUSSION WITH CC
|
Facility
|
IP
|
$11,398.64
|
|
|
Service Code
|
MSDRG 089
|
| Min. Negotiated Rate |
$8,662.96 |
| Max. Negotiated Rate |
$11,398.64 |
| Rate for Payer: Aetna Medicare |
$9,483.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,398.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,398.64
|
| Rate for Payer: BCBS MAPPO |
$9,118.91
|
| Rate for Payer: BCN Medicare Advantage |
$9,118.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,118.91
|
| Rate for Payer: Mclaren Medicare |
$9,118.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,574.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,486.75
|
| Rate for Payer: PACE Medicare |
$8,662.96
|
| Rate for Payer: PACE SWMI |
$9,118.91
|
| Rate for Payer: PHP Medicare Advantage |
$9,118.91
|
| Rate for Payer: Priority Health Medicare |
$9,118.91
|
| Rate for Payer: Railroad Medicare Medicare |
$9,118.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,118.91
|
| Rate for Payer: UHC Medicare Advantage |
$9,118.91
|
| Rate for Payer: VA VA |
$9,118.91
|
|
|
MS-DRG 42.00: CONCUSSION WITH MCC
|
Facility
|
IP
|
$14,824.66
|
|
|
Service Code
|
MSDRG 088
|
| Min. Negotiated Rate |
$11,266.74 |
| Max. Negotiated Rate |
$14,824.66 |
| Rate for Payer: Aetna Medicare |
$12,334.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,824.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,824.66
|
| Rate for Payer: BCBS MAPPO |
$11,859.73
|
| Rate for Payer: BCN Medicare Advantage |
$11,859.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,859.73
|
| Rate for Payer: Mclaren Medicare |
$11,859.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,452.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,638.69
|
| Rate for Payer: PACE Medicare |
$11,266.74
|
| Rate for Payer: PACE SWMI |
$11,859.73
|
| Rate for Payer: PHP Medicare Advantage |
$11,859.73
|
| Rate for Payer: Priority Health Medicare |
$11,859.73
|
| Rate for Payer: Railroad Medicare Medicare |
$11,859.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,859.73
|
| Rate for Payer: UHC Medicare Advantage |
$11,859.73
|
| Rate for Payer: VA VA |
$11,859.73
|
|
|
MS-DRG 42.00: CONCUSSION WITHOUT CC/MCC
|
Facility
|
IP
|
$9,225.23
|
|
|
Service Code
|
MSDRG 090
|
| Min. Negotiated Rate |
$7,011.17 |
| Max. Negotiated Rate |
$9,225.23 |
| Rate for Payer: Aetna Medicare |
$7,675.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,225.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,225.23
|
| Rate for Payer: BCBS MAPPO |
$7,380.18
|
| Rate for Payer: BCN Medicare Advantage |
$7,380.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,380.18
|
| Rate for Payer: Mclaren Medicare |
$7,380.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,749.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,487.21
|
| Rate for Payer: PACE Medicare |
$7,011.17
|
| Rate for Payer: PACE SWMI |
$7,380.18
|
| Rate for Payer: PHP Medicare Advantage |
$7,380.18
|
| Rate for Payer: Priority Health Medicare |
$7,380.18
|
| Rate for Payer: Railroad Medicare Medicare |
$7,380.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,380.18
|
| Rate for Payer: UHC Medicare Advantage |
$7,380.18
|
| Rate for Payer: VA VA |
$7,380.18
|
|
|
MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$12,264.75
|
|
|
Service Code
|
MSDRG 546
|
| Min. Negotiated Rate |
$9,321.21 |
| Max. Negotiated Rate |
$12,264.75 |
| Rate for Payer: Aetna Medicare |
$10,204.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,264.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,264.75
|
| Rate for Payer: BCBS MAPPO |
$9,811.80
|
| Rate for Payer: BCN Medicare Advantage |
$9,811.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,811.80
|
| Rate for Payer: Mclaren Medicare |
$9,811.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,302.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,283.57
|
| Rate for Payer: PACE Medicare |
$9,321.21
|
| Rate for Payer: PACE SWMI |
$9,811.80
|
| Rate for Payer: PHP Medicare Advantage |
$9,811.80
|
| Rate for Payer: Priority Health Medicare |
$9,811.80
|
| Rate for Payer: Railroad Medicare Medicare |
$9,811.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,811.80
|
| Rate for Payer: UHC Medicare Advantage |
$9,811.80
|
| Rate for Payer: VA VA |
$9,811.80
|
|
|
MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$26,118.69
|
|
|
Service Code
|
MSDRG 545
|
| Min. Negotiated Rate |
$19,850.20 |
| Max. Negotiated Rate |
$26,118.69 |
| Rate for Payer: Aetna Medicare |
$21,730.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,118.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,118.69
|
| Rate for Payer: BCBS MAPPO |
$20,894.95
|
| Rate for Payer: BCN Medicare Advantage |
$20,894.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,894.95
|
| Rate for Payer: Mclaren Medicare |
$20,894.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,939.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,029.19
|
| Rate for Payer: PACE Medicare |
$19,850.20
|
| Rate for Payer: PACE SWMI |
$20,894.95
|
| Rate for Payer: PHP Medicare Advantage |
$20,894.95
|
| Rate for Payer: Priority Health Medicare |
$20,894.95
|
| Rate for Payer: Railroad Medicare Medicare |
$20,894.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,894.95
|
| Rate for Payer: UHC Medicare Advantage |
$20,894.95
|
| Rate for Payer: VA VA |
$20,894.95
|
|
|
MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$8,101.09
|
|
|
Service Code
|
MSDRG 547
|
| Min. Negotiated Rate |
$6,156.83 |
| Max. Negotiated Rate |
$8,101.09 |
| Rate for Payer: Aetna Medicare |
$6,740.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,101.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,101.09
|
| Rate for Payer: BCBS MAPPO |
$6,480.87
|
| Rate for Payer: BCN Medicare Advantage |
$6,480.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,480.87
|
| Rate for Payer: Mclaren Medicare |
$6,480.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,804.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,453.00
|
| Rate for Payer: PACE Medicare |
$6,156.83
|
| Rate for Payer: PACE SWMI |
$6,480.87
|
| Rate for Payer: PHP Medicare Advantage |
$6,480.87
|
| Rate for Payer: Priority Health Medicare |
$6,480.87
|
| Rate for Payer: Railroad Medicare Medicare |
$6,480.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,480.87
|
| Rate for Payer: UHC Medicare Advantage |
$6,480.87
|
| Rate for Payer: VA VA |
$6,480.87
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC
|
Facility
|
IP
|
$79,639.14
|
|
|
Service Code
|
MSDRG 233
|
| Min. Negotiated Rate |
$60,525.74 |
| Max. Negotiated Rate |
$79,639.14 |
| Rate for Payer: Aetna Medicare |
$66,259.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79,639.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79,639.14
|
| Rate for Payer: BCBS MAPPO |
$63,711.31
|
| Rate for Payer: BCN Medicare Advantage |
$63,711.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63,711.31
|
| Rate for Payer: Mclaren Medicare |
$63,711.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66,896.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73,268.01
|
| Rate for Payer: PACE Medicare |
$60,525.74
|
| Rate for Payer: PACE SWMI |
$63,711.31
|
| Rate for Payer: PHP Medicare Advantage |
$63,711.31
|
| Rate for Payer: Priority Health Medicare |
$63,711.31
|
| Rate for Payer: Railroad Medicare Medicare |
$63,711.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$63,711.31
|
| Rate for Payer: UHC Medicare Advantage |
$63,711.31
|
| Rate for Payer: VA VA |
$63,711.31
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC
|
Facility
|
IP
|
$54,381.96
|
|
|
Service Code
|
MSDRG 234
|
| Min. Negotiated Rate |
$41,330.29 |
| Max. Negotiated Rate |
$54,381.96 |
| Rate for Payer: Aetna Medicare |
$45,245.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54,381.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54,381.96
|
| Rate for Payer: BCBS MAPPO |
$43,505.57
|
| Rate for Payer: BCN Medicare Advantage |
$43,505.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43,505.57
|
| Rate for Payer: Mclaren Medicare |
$43,505.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45,680.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50,031.41
|
| Rate for Payer: PACE Medicare |
$41,330.29
|
| Rate for Payer: PACE SWMI |
$43,505.57
|
| Rate for Payer: PHP Medicare Advantage |
$43,505.57
|
| Rate for Payer: Priority Health Medicare |
$43,505.57
|
| Rate for Payer: Railroad Medicare Medicare |
$43,505.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$43,505.57
|
| Rate for Payer: UHC Medicare Advantage |
$43,505.57
|
| Rate for Payer: VA VA |
$43,505.57
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$60,088.66
|
|
|
Service Code
|
MSDRG 235
|
| Min. Negotiated Rate |
$45,667.38 |
| Max. Negotiated Rate |
$60,088.66 |
| Rate for Payer: Aetna Medicare |
$49,993.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60,088.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60,088.66
|
| Rate for Payer: BCBS MAPPO |
$48,070.93
|
| Rate for Payer: BCN Medicare Advantage |
$48,070.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48,070.93
|
| Rate for Payer: Mclaren Medicare |
$48,070.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50,474.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55,281.57
|
| Rate for Payer: PACE Medicare |
$45,667.38
|
| Rate for Payer: PACE SWMI |
$48,070.93
|
| Rate for Payer: PHP Medicare Advantage |
$48,070.93
|
| Rate for Payer: Priority Health Medicare |
$48,070.93
|
| Rate for Payer: Railroad Medicare Medicare |
$48,070.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$48,070.93
|
| Rate for Payer: UHC Medicare Advantage |
$48,070.93
|
| Rate for Payer: VA VA |
$48,070.93
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$42,158.14
|
|
|
Service Code
|
MSDRG 236
|
| Min. Negotiated Rate |
$32,040.18 |
| Max. Negotiated Rate |
$42,158.14 |
| Rate for Payer: Aetna Medicare |
$35,075.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42,158.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42,158.14
|
| Rate for Payer: BCBS MAPPO |
$33,726.51
|
| Rate for Payer: BCN Medicare Advantage |
$33,726.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33,726.51
|
| Rate for Payer: Mclaren Medicare |
$33,726.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35,412.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38,785.49
|
| Rate for Payer: PACE Medicare |
$32,040.18
|
| Rate for Payer: PACE SWMI |
$33,726.51
|
| Rate for Payer: PHP Medicare Advantage |
$33,726.51
|
| Rate for Payer: Priority Health Medicare |
$33,726.51
|
| Rate for Payer: Railroad Medicare Medicare |
$33,726.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$33,726.51
|
| Rate for Payer: UHC Medicare Advantage |
$33,726.51
|
| Rate for Payer: VA VA |
$33,726.51
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
|
IP
|
$86,291.90
|
|
|
Service Code
|
MSDRG 231
|
| Min. Negotiated Rate |
$65,581.84 |
| Max. Negotiated Rate |
$86,291.90 |
| Rate for Payer: Aetna Medicare |
$71,794.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86,291.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86,291.90
|
| Rate for Payer: BCBS MAPPO |
$69,033.52
|
| Rate for Payer: BCN Medicare Advantage |
$69,033.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69,033.52
|
| Rate for Payer: Mclaren Medicare |
$69,033.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72,485.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79,388.55
|
| Rate for Payer: PACE Medicare |
$65,581.84
|
| Rate for Payer: PACE SWMI |
$69,033.52
|
| Rate for Payer: PHP Medicare Advantage |
$69,033.52
|
| Rate for Payer: Priority Health Medicare |
$69,033.52
|
| Rate for Payer: Railroad Medicare Medicare |
$69,033.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69,033.52
|
| Rate for Payer: UHC Medicare Advantage |
$69,033.52
|
| Rate for Payer: VA VA |
$69,033.52
|
|
