|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$18,081.06
|
|
|
Service Code
|
APR-DRG 6121
|
| Min. Negotiated Rate |
$17,220.06 |
| Max. Negotiated Rate |
$18,081.06 |
| Rate for Payer: BCBS Complete |
$18,081.06
|
| Rate for Payer: Mclaren Medicaid |
$17,220.06
|
| Rate for Payer: Meridian Medicaid |
$18,081.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,220.06
|
| Rate for Payer: UHC Medicaid |
$17,220.06
|
| Rate for Payer: UHCCP Medicaid |
$17,220.06
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJ
|
Facility
|
IP
|
$39,823.12
|
|
|
Service Code
|
APR-DRG 6123
|
| Min. Negotiated Rate |
$37,926.78 |
| Max. Negotiated Rate |
$39,823.12 |
| Rate for Payer: BCBS Complete |
$39,823.12
|
| Rate for Payer: Mclaren Medicaid |
$37,926.78
|
| Rate for Payer: Meridian Medicaid |
$39,823.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$37,926.78
|
| Rate for Payer: UHC Medicaid |
$37,926.78
|
| Rate for Payer: UHCCP Medicaid |
$37,926.78
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$86,343.56
|
|
|
Service Code
|
APR-DRG 6093
|
| Min. Negotiated Rate |
$82,231.96 |
| Max. Negotiated Rate |
$86,343.56 |
| Rate for Payer: BCBS Complete |
$86,343.56
|
| Rate for Payer: Mclaren Medicaid |
$82,231.96
|
| Rate for Payer: Meridian Medicaid |
$86,343.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$82,231.96
|
| Rate for Payer: UHC Medicaid |
$82,231.96
|
| Rate for Payer: UHCCP Medicaid |
$82,231.96
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$48,484.72
|
|
|
Service Code
|
APR-DRG 6092
|
| Min. Negotiated Rate |
$46,175.92 |
| Max. Negotiated Rate |
$48,484.72 |
| Rate for Payer: BCBS Complete |
$48,484.72
|
| Rate for Payer: Mclaren Medicaid |
$46,175.92
|
| Rate for Payer: Meridian Medicaid |
$48,484.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$46,175.92
|
| Rate for Payer: UHC Medicaid |
$46,175.92
|
| Rate for Payer: UHCCP Medicaid |
$46,175.92
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$191,458.24
|
|
|
Service Code
|
APR-DRG 6094
|
| Min. Negotiated Rate |
$182,341.18 |
| Max. Negotiated Rate |
$191,458.24 |
| Rate for Payer: BCBS Complete |
$191,458.24
|
| Rate for Payer: Mclaren Medicaid |
$182,341.18
|
| Rate for Payer: Meridian Medicaid |
$191,458.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$182,341.18
|
| Rate for Payer: UHC Medicaid |
$182,341.18
|
| Rate for Payer: UHCCP Medicaid |
$182,341.18
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$40,008.35
|
|
|
Service Code
|
APR-DRG 6091
|
| Min. Negotiated Rate |
$38,103.19 |
| Max. Negotiated Rate |
$40,008.35 |
| Rate for Payer: BCBS Complete |
$40,008.35
|
| Rate for Payer: Mclaren Medicaid |
$38,103.19
|
| Rate for Payer: Meridian Medicaid |
$40,008.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$38,103.19
|
| Rate for Payer: UHC Medicaid |
$38,103.19
|
| Rate for Payer: UHCCP Medicaid |
$38,103.19
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$133,913.02
|
|
|
Service Code
|
APR-DRG 5883
|
| Min. Negotiated Rate |
$127,536.21 |
| Max. Negotiated Rate |
$133,913.02 |
| Rate for Payer: BCBS Complete |
$133,913.02
|
| Rate for Payer: Mclaren Medicaid |
$127,536.21
|
| Rate for Payer: Meridian Medicaid |
$133,913.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$127,536.21
|
| Rate for Payer: UHC Medicaid |
$127,536.21
|
| Rate for Payer: UHCCP Medicaid |
$127,536.21
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$234,442.98
|
|
|
Service Code
|
APR-DRG 5884
|
| Min. Negotiated Rate |
$223,279.03 |
| Max. Negotiated Rate |
$234,442.98 |
| Rate for Payer: BCBS Complete |
$234,442.98
|
| Rate for Payer: Mclaren Medicaid |
$223,279.03
|
| Rate for Payer: Meridian Medicaid |
$234,442.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$223,279.03
|
| Rate for Payer: UHC Medicaid |
$223,279.03
|
| Rate for Payer: UHCCP Medicaid |
$223,279.03
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$153,468.65
|
|
|
Service Code
|
APR-DRG 5881
|
| Min. Negotiated Rate |
$146,160.62 |
| Max. Negotiated Rate |
$153,468.65 |
| Rate for Payer: BCBS Complete |
$153,468.65
|
| Rate for Payer: Mclaren Medicaid |
$146,160.62
|
| Rate for Payer: Meridian Medicaid |
$153,468.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$146,160.62
|
| Rate for Payer: UHC Medicaid |
$146,160.62
|
| Rate for Payer: UHCCP Medicaid |
$146,160.62
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$163,920.80
|
|
|
Service Code
|
APR-DRG 5882
|
| Min. Negotiated Rate |
$156,115.05 |
| Max. Negotiated Rate |
$163,920.80 |
| Rate for Payer: BCBS Complete |
$163,920.80
|
| Rate for Payer: Mclaren Medicaid |
$156,115.05
|
| Rate for Payer: Meridian Medicaid |
$163,920.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$156,115.05
|
| Rate for Payer: UHC Medicaid |
$156,115.05
|
| Rate for Payer: UHCCP Medicaid |
$156,115.05
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLE
|
Facility
|
IP
|
$8,969.71
|
|
|
Service Code
|
APR-DRG 6263
|
| Min. Negotiated Rate |
$8,542.58 |
| Max. Negotiated Rate |
$8,969.71 |
| Rate for Payer: BCBS Complete |
$8,969.71
|
| Rate for Payer: Mclaren Medicaid |
$8,542.58
|
| Rate for Payer: Meridian Medicaid |
$8,969.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,542.58
|
| Rate for Payer: UHC Medicaid |
$8,542.58
|
| Rate for Payer: UHCCP Medicaid |
$8,542.58
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLE
|
Facility
|
IP
|
$4,234.25
|
|
|
Service Code
|
APR-DRG 6261
|
| Min. Negotiated Rate |
$4,032.62 |
| Max. Negotiated Rate |
$4,234.25 |
| Rate for Payer: BCBS Complete |
$4,234.25
|
| Rate for Payer: Mclaren Medicaid |
$4,032.62
|
| Rate for Payer: Meridian Medicaid |
$4,234.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,032.62
|
| Rate for Payer: UHC Medicaid |
$4,032.62
|
| Rate for Payer: UHCCP Medicaid |
$4,032.62
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLE
|
Facility
|
IP
|
$9,501.18
|
|
|
Service Code
|
APR-DRG 6264
|
| Min. Negotiated Rate |
$9,048.74 |
| Max. Negotiated Rate |
$9,501.18 |
| Rate for Payer: BCBS Complete |
$9,501.18
|
| Rate for Payer: Mclaren Medicaid |
$9,048.74
|
| Rate for Payer: Meridian Medicaid |
$9,501.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,048.74
|
| Rate for Payer: UHC Medicaid |
$9,048.74
|
| Rate for Payer: UHCCP Medicaid |
$9,048.74
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLE
|
Facility
|
IP
|
$6,469.71
|
|
|
Service Code
|
APR-DRG 6262
|
| Min. Negotiated Rate |
$6,161.63 |
| Max. Negotiated Rate |
$6,469.71 |
| Rate for Payer: BCBS Complete |
$6,469.71
|
| Rate for Payer: Mclaren Medicaid |
$6,161.63
|
| Rate for Payer: Meridian Medicaid |
$6,469.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,161.63
|
| Rate for Payer: UHC Medicaid |
$6,161.63
|
| Rate for Payer: UHCCP Medicaid |
$6,161.63
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$10,510.86
|
|
|
Service Code
|
APR-DRG 6232
|
| Min. Negotiated Rate |
$10,010.35 |
| Max. Negotiated Rate |
$10,510.86 |
| Rate for Payer: BCBS Complete |
$10,510.86
|
| Rate for Payer: Mclaren Medicaid |
$10,010.35
|
| Rate for Payer: Meridian Medicaid |
$10,510.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,010.35
|
| Rate for Payer: UHC Medicaid |
$10,010.35
|
| Rate for Payer: UHCCP Medicaid |
$10,010.35
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$47,117.29
|
|
|
Service Code
|
APR-DRG 6234
|
| Min. Negotiated Rate |
$44,873.61 |
| Max. Negotiated Rate |
$47,117.29 |
| Rate for Payer: BCBS Complete |
$47,117.29
|
| Rate for Payer: Mclaren Medicaid |
$44,873.61
|
| Rate for Payer: Meridian Medicaid |
$47,117.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$44,873.61
|
| Rate for Payer: UHC Medicaid |
$44,873.61
|
| Rate for Payer: UHCCP Medicaid |
$44,873.61
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$7,170.68
|
|
|
Service Code
|
APR-DRG 6231
|
| Min. Negotiated Rate |
$6,829.22 |
| Max. Negotiated Rate |
$7,170.68 |
| Rate for Payer: BCBS Complete |
$7,170.68
|
| Rate for Payer: Mclaren Medicaid |
$6,829.22
|
| Rate for Payer: Meridian Medicaid |
$7,170.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,829.22
|
| Rate for Payer: UHC Medicaid |
$6,829.22
|
| Rate for Payer: UHCCP Medicaid |
$6,829.22
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$18,861.93
|
|
|
Service Code
|
APR-DRG 6233
|
| Min. Negotiated Rate |
$17,963.74 |
| Max. Negotiated Rate |
$18,861.93 |
| Rate for Payer: BCBS Complete |
$18,861.93
|
| Rate for Payer: Mclaren Medicaid |
$17,963.74
|
| Rate for Payer: Meridian Medicaid |
$18,861.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,963.74
|
| Rate for Payer: UHC Medicaid |
$17,963.74
|
| Rate for Payer: UHCCP Medicaid |
$17,963.74
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$22,179.71
|
|
|
Service Code
|
APR-DRG 6213
|
| Min. Negotiated Rate |
$21,123.54 |
| Max. Negotiated Rate |
$22,179.71 |
| Rate for Payer: BCBS Complete |
$22,179.71
|
| Rate for Payer: Mclaren Medicaid |
$21,123.54
|
| Rate for Payer: Meridian Medicaid |
$22,179.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,123.54
|
| Rate for Payer: UHC Medicaid |
$21,123.54
|
| Rate for Payer: UHCCP Medicaid |
$21,123.54
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$5,363.78
|
|
|
Service Code
|
APR-DRG 6211
|
| Min. Negotiated Rate |
$5,108.37 |
| Max. Negotiated Rate |
$5,363.78 |
| Rate for Payer: BCBS Complete |
$5,363.78
|
| Rate for Payer: Mclaren Medicaid |
$5,108.37
|
| Rate for Payer: Meridian Medicaid |
$5,363.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,108.37
|
| Rate for Payer: UHC Medicaid |
$5,108.37
|
| Rate for Payer: UHCCP Medicaid |
$5,108.37
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$13,012.67
|
|
|
Service Code
|
APR-DRG 6212
|
| Min. Negotiated Rate |
$12,393.02 |
| Max. Negotiated Rate |
$13,012.67 |
| Rate for Payer: BCBS Complete |
$13,012.67
|
| Rate for Payer: Mclaren Medicaid |
$12,393.02
|
| Rate for Payer: Meridian Medicaid |
$13,012.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,393.02
|
| Rate for Payer: UHC Medicaid |
$12,393.02
|
| Rate for Payer: UHCCP Medicaid |
$12,393.02
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$40,275.90
|
|
|
Service Code
|
APR-DRG 6214
|
| Min. Negotiated Rate |
$38,358.00 |
| Max. Negotiated Rate |
$40,275.90 |
| Rate for Payer: BCBS Complete |
$40,275.90
|
| Rate for Payer: Mclaren Medicaid |
$38,358.00
|
| Rate for Payer: Meridian Medicaid |
$40,275.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$38,358.00
|
| Rate for Payer: UHC Medicaid |
$38,358.00
|
| Rate for Payer: UHCCP Medicaid |
$38,358.00
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$14,387.97
|
|
|
Service Code
|
APR-DRG 6252
|
| Min. Negotiated Rate |
$13,702.83 |
| Max. Negotiated Rate |
$14,387.97 |
| Rate for Payer: BCBS Complete |
$14,387.97
|
| Rate for Payer: Mclaren Medicaid |
$13,702.83
|
| Rate for Payer: Meridian Medicaid |
$14,387.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,702.83
|
| Rate for Payer: UHC Medicaid |
$13,702.83
|
| Rate for Payer: UHCCP Medicaid |
$13,702.83
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$22,857.07
|
|
|
Service Code
|
APR-DRG 6253
|
| Min. Negotiated Rate |
$21,768.64 |
| Max. Negotiated Rate |
$22,857.07 |
| Rate for Payer: BCBS Complete |
$22,857.07
|
| Rate for Payer: Mclaren Medicaid |
$21,768.64
|
| Rate for Payer: Meridian Medicaid |
$22,857.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,768.64
|
| Rate for Payer: UHC Medicaid |
$21,768.64
|
| Rate for Payer: UHCCP Medicaid |
$21,768.64
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$60,698.36
|
|
|
Service Code
|
APR-DRG 6254
|
| Min. Negotiated Rate |
$57,807.96 |
| Max. Negotiated Rate |
$60,698.36 |
| Rate for Payer: BCBS Complete |
$60,698.36
|
| Rate for Payer: Mclaren Medicaid |
$57,807.96
|
| Rate for Payer: Meridian Medicaid |
$60,698.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$57,807.96
|
| Rate for Payer: UHC Medicaid |
$57,807.96
|
| Rate for Payer: UHCCP Medicaid |
$57,807.96
|
|