|
MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
|
IP
|
$62,360.21
|
|
|
Service Code
|
MSDRG 232
|
| Min. Negotiated Rate |
$47,393.76 |
| Max. Negotiated Rate |
$62,360.21 |
| Rate for Payer: Aetna Medicare |
$51,883.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62,360.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62,360.21
|
| Rate for Payer: BCBS MAPPO |
$49,888.17
|
| Rate for Payer: BCN Medicare Advantage |
$49,888.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,888.17
|
| Rate for Payer: Mclaren Medicare |
$49,888.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52,382.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57,371.40
|
| Rate for Payer: PACE Medicare |
$47,393.76
|
| Rate for Payer: PACE SWMI |
$49,888.17
|
| Rate for Payer: PHP Medicare Advantage |
$49,888.17
|
| Rate for Payer: Priority Health Medicare |
$49,888.17
|
| Rate for Payer: Railroad Medicare Medicare |
$49,888.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$49,888.17
|
| Rate for Payer: UHC Medicare Advantage |
$49,888.17
|
| Rate for Payer: VA VA |
$49,888.17
|
|
|
MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$43,648.53
|
|
|
Service Code
|
MSDRG 323
|
| Min. Negotiated Rate |
$33,172.88 |
| Max. Negotiated Rate |
$43,648.53 |
| Rate for Payer: Aetna Medicare |
$36,315.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43,648.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43,648.53
|
| Rate for Payer: BCBS MAPPO |
$34,918.82
|
| Rate for Payer: BCN Medicare Advantage |
$34,918.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34,918.82
|
| Rate for Payer: Mclaren Medicare |
$34,918.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36,664.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40,156.64
|
| Rate for Payer: PACE Medicare |
$33,172.88
|
| Rate for Payer: PACE SWMI |
$34,918.82
|
| Rate for Payer: PHP Medicare Advantage |
$34,918.82
|
| Rate for Payer: Priority Health Medicare |
$34,918.82
|
| Rate for Payer: Railroad Medicare Medicare |
$34,918.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$34,918.82
|
| Rate for Payer: UHC Medicare Advantage |
$34,918.82
|
| Rate for Payer: VA VA |
$34,918.82
|
|
|
MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$32,879.69
|
|
|
Service Code
|
MSDRG 324
|
| Min. Negotiated Rate |
$24,988.56 |
| Max. Negotiated Rate |
$32,879.69 |
| Rate for Payer: Aetna Medicare |
$27,355.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,879.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,879.69
|
| Rate for Payer: BCBS MAPPO |
$26,303.75
|
| Rate for Payer: BCN Medicare Advantage |
$26,303.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,303.75
|
| Rate for Payer: Mclaren Medicare |
$26,303.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,618.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,249.31
|
| Rate for Payer: PACE Medicare |
$24,988.56
|
| Rate for Payer: PACE SWMI |
$26,303.75
|
| Rate for Payer: PHP Medicare Advantage |
$26,303.75
|
| Rate for Payer: Priority Health Medicare |
$26,303.75
|
| Rate for Payer: Railroad Medicare Medicare |
$26,303.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,303.75
|
| Rate for Payer: UHC Medicare Advantage |
$26,303.75
|
| Rate for Payer: VA VA |
$26,303.75
|
|
|
MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$29,510.28
|
|
|
Service Code
|
MSDRG 325
|
| Min. Negotiated Rate |
$22,427.81 |
| Max. Negotiated Rate |
$29,510.28 |
| Rate for Payer: Aetna Medicare |
$24,552.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,510.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,510.28
|
| Rate for Payer: BCBS MAPPO |
$23,608.22
|
| Rate for Payer: BCN Medicare Advantage |
$23,608.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,608.22
|
| Rate for Payer: Mclaren Medicare |
$23,608.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,788.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,149.45
|
| Rate for Payer: PACE Medicare |
$22,427.81
|
| Rate for Payer: PACE SWMI |
$23,608.22
|
| Rate for Payer: PHP Medicare Advantage |
$23,608.22
|
| Rate for Payer: Priority Health Medicare |
$23,608.22
|
| Rate for Payer: Railroad Medicare Medicare |
$23,608.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,608.22
|
| Rate for Payer: UHC Medicare Advantage |
$23,608.22
|
| Rate for Payer: VA VA |
$23,608.22
|
|
|
MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC
|
Facility
|
IP
|
$16,189.62
|
|
|
Service Code
|
MSDRG 073
|
| Min. Negotiated Rate |
$12,304.11 |
| Max. Negotiated Rate |
$16,189.62 |
| Rate for Payer: Aetna Medicare |
$13,469.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,189.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,189.62
|
| Rate for Payer: BCBS MAPPO |
$12,951.70
|
| Rate for Payer: BCN Medicare Advantage |
$12,951.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,951.70
|
| Rate for Payer: Mclaren Medicare |
$12,951.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,599.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,894.45
|
| Rate for Payer: PACE Medicare |
$12,304.11
|
| Rate for Payer: PACE SWMI |
$12,951.70
|
| Rate for Payer: PHP Medicare Advantage |
$12,951.70
|
| Rate for Payer: Priority Health Medicare |
$12,951.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12,951.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,951.70
|
| Rate for Payer: UHC Medicare Advantage |
$12,951.70
|
| Rate for Payer: VA VA |
$12,951.70
|
|
|
MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$11,098.12
|
|
|
Service Code
|
MSDRG 074
|
| Min. Negotiated Rate |
$8,434.58 |
| Max. Negotiated Rate |
$11,098.12 |
| Rate for Payer: Aetna Medicare |
$9,233.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,098.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,098.12
|
| Rate for Payer: BCBS MAPPO |
$8,878.50
|
| Rate for Payer: BCN Medicare Advantage |
$8,878.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,878.50
|
| Rate for Payer: Mclaren Medicare |
$8,878.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,322.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,210.27
|
| Rate for Payer: PACE Medicare |
$8,434.58
|
| Rate for Payer: PACE SWMI |
$8,878.50
|
| Rate for Payer: PHP Medicare Advantage |
$8,878.50
|
| Rate for Payer: Priority Health Medicare |
$8,878.50
|
| Rate for Payer: Railroad Medicare Medicare |
$8,878.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,878.50
|
| Rate for Payer: UHC Medicare Advantage |
$8,878.50
|
| Rate for Payer: VA VA |
$8,878.50
|
|
|
MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$31,498.56
|
|
|
Service Code
|
MSDRG 026
|
| Min. Negotiated Rate |
$23,938.91 |
| Max. Negotiated Rate |
$31,498.56 |
| Rate for Payer: Aetna Medicare |
$26,206.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,498.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,498.56
|
| Rate for Payer: BCBS MAPPO |
$25,198.85
|
| Rate for Payer: BCN Medicare Advantage |
$25,198.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,198.85
|
| Rate for Payer: Mclaren Medicare |
$25,198.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,458.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,978.68
|
| Rate for Payer: PACE Medicare |
$23,938.91
|
| Rate for Payer: PACE SWMI |
$25,198.85
|
| Rate for Payer: PHP Medicare Advantage |
$25,198.85
|
| Rate for Payer: Priority Health Medicare |
$25,198.85
|
| Rate for Payer: Railroad Medicare Medicare |
$25,198.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,198.85
|
| Rate for Payer: UHC Medicare Advantage |
$25,198.85
|
| Rate for Payer: VA VA |
$25,198.85
|
|
|
MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$45,802.72
|
|
|
Service Code
|
MSDRG 025
|
| Min. Negotiated Rate |
$34,810.07 |
| Max. Negotiated Rate |
$45,802.72 |
| Rate for Payer: Aetna Medicare |
$38,107.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,802.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,802.72
|
| Rate for Payer: BCBS MAPPO |
$36,642.18
|
| Rate for Payer: BCN Medicare Advantage |
$36,642.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,642.18
|
| Rate for Payer: Mclaren Medicare |
$36,642.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,474.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,138.51
|
| Rate for Payer: PACE Medicare |
$34,810.07
|
| Rate for Payer: PACE SWMI |
$36,642.18
|
| Rate for Payer: PHP Medicare Advantage |
$36,642.18
|
| Rate for Payer: Priority Health Medicare |
$36,642.18
|
| Rate for Payer: Railroad Medicare Medicare |
$36,642.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$36,642.18
|
| Rate for Payer: UHC Medicare Advantage |
$36,642.18
|
| Rate for Payer: VA VA |
$36,642.18
|
|
|
MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$25,520.69
|
|
|
Service Code
|
MSDRG 027
|
| Min. Negotiated Rate |
$19,395.72 |
| Max. Negotiated Rate |
$25,520.69 |
| Rate for Payer: Aetna Medicare |
$21,233.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,520.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,520.69
|
| Rate for Payer: BCBS MAPPO |
$20,416.55
|
| Rate for Payer: BCN Medicare Advantage |
$20,416.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,416.55
|
| Rate for Payer: Mclaren Medicare |
$20,416.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,437.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,479.03
|
| Rate for Payer: PACE Medicare |
$19,395.72
|
| Rate for Payer: PACE SWMI |
$20,416.55
|
| Rate for Payer: PHP Medicare Advantage |
$20,416.55
|
| Rate for Payer: Priority Health Medicare |
$20,416.55
|
| Rate for Payer: Railroad Medicare Medicare |
$20,416.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,416.55
|
| Rate for Payer: UHC Medicare Advantage |
$20,416.55
|
| Rate for Payer: VA VA |
$20,416.55
|
|
|
MS-DRG 42.00: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$69,641.31
|
|
|
Service Code
|
MSDRG 955
|
| Min. Negotiated Rate |
$52,927.40 |
| Max. Negotiated Rate |
$69,641.31 |
| Rate for Payer: Aetna Medicare |
$57,941.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69,641.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69,641.31
|
| Rate for Payer: BCBS MAPPO |
$55,713.05
|
| Rate for Payer: BCN Medicare Advantage |
$55,713.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55,713.05
|
| Rate for Payer: Mclaren Medicare |
$55,713.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58,498.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64,070.01
|
| Rate for Payer: PACE Medicare |
$52,927.40
|
| Rate for Payer: PACE SWMI |
$55,713.05
|
| Rate for Payer: PHP Medicare Advantage |
$55,713.05
|
| Rate for Payer: Priority Health Medicare |
$55,713.05
|
| Rate for Payer: Railroad Medicare Medicare |
$55,713.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$55,713.05
|
| Rate for Payer: UHC Medicare Advantage |
$55,713.05
|
| Rate for Payer: VA VA |
$55,713.05
|
|
|
MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$58,276.49
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$44,290.13 |
| Max. Negotiated Rate |
$58,276.49 |
| Rate for Payer: Aetna Medicare |
$48,486.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58,276.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58,276.49
|
| Rate for Payer: BCBS MAPPO |
$46,621.19
|
| Rate for Payer: BCN Medicare Advantage |
$46,621.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,621.19
|
| Rate for Payer: Mclaren Medicare |
$46,621.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48,952.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53,614.37
|
| Rate for Payer: PACE Medicare |
$44,290.13
|
| Rate for Payer: PACE SWMI |
$46,621.19
|
| Rate for Payer: PHP Medicare Advantage |
$46,621.19
|
| Rate for Payer: Priority Health Medicare |
$46,621.19
|
| Rate for Payer: Railroad Medicare Medicare |
$46,621.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$46,621.19
|
| Rate for Payer: UHC Medicare Advantage |
$46,621.19
|
| Rate for Payer: VA VA |
$46,621.19
|
|
|
MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$39,017.41
|
|
|
Service Code
|
MSDRG 024
|
| Min. Negotiated Rate |
$29,653.23 |
| Max. Negotiated Rate |
$39,017.41 |
| Rate for Payer: Aetna Medicare |
$32,462.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,017.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,017.41
|
| Rate for Payer: BCBS MAPPO |
$31,213.93
|
| Rate for Payer: BCN Medicare Advantage |
$31,213.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,213.93
|
| Rate for Payer: Mclaren Medicare |
$31,213.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,774.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,896.02
|
| Rate for Payer: PACE Medicare |
$29,653.23
|
| Rate for Payer: PACE SWMI |
$31,213.93
|
| Rate for Payer: PHP Medicare Advantage |
$31,213.93
|
| Rate for Payer: Priority Health Medicare |
$31,213.93
|
| Rate for Payer: Railroad Medicare Medicare |
$31,213.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,213.93
|
| Rate for Payer: UHC Medicare Advantage |
$31,213.93
|
| Rate for Payer: VA VA |
$31,213.93
|
|
|
MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC
|
Facility
|
IP
|
$20,321.92
|
|
|
Service Code
|
MSDRG 744
|
| Min. Negotiated Rate |
$15,444.66 |
| Max. Negotiated Rate |
$20,321.92 |
| Rate for Payer: Aetna Medicare |
$16,907.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,321.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,321.92
|
| Rate for Payer: BCBS MAPPO |
$16,257.54
|
| Rate for Payer: BCN Medicare Advantage |
$16,257.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,257.54
|
| Rate for Payer: Mclaren Medicare |
$16,257.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,070.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,696.17
|
| Rate for Payer: PACE Medicare |
$15,444.66
|
| Rate for Payer: PACE SWMI |
$16,257.54
|
| Rate for Payer: PHP Medicare Advantage |
$16,257.54
|
| Rate for Payer: Priority Health Medicare |
$16,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$16,257.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,257.54
|
| Rate for Payer: UHC Medicare Advantage |
$16,257.54
|
| Rate for Payer: VA VA |
$16,257.54
|
|
|
MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC
|
Facility
|
IP
|
$10,920.05
|
|
|
Service Code
|
MSDRG 745
|
| Min. Negotiated Rate |
$8,299.24 |
| Max. Negotiated Rate |
$10,920.05 |
| Rate for Payer: Aetna Medicare |
$9,085.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,920.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,920.05
|
| Rate for Payer: BCBS MAPPO |
$8,736.04
|
| Rate for Payer: BCN Medicare Advantage |
$8,736.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,736.04
|
| Rate for Payer: Mclaren Medicare |
$8,736.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,172.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,046.45
|
| Rate for Payer: PACE Medicare |
$8,299.24
|
| Rate for Payer: PACE SWMI |
$8,736.04
|
| Rate for Payer: PHP Medicare Advantage |
$8,736.04
|
| Rate for Payer: Priority Health Medicare |
$8,736.04
|
| Rate for Payer: Railroad Medicare Medicare |
$8,736.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,736.04
|
| Rate for Payer: UHC Medicare Advantage |
$8,736.04
|
| Rate for Payer: VA VA |
$8,736.04
|
|
|
MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC
|
Facility
|
IP
|
$12,976.06
|
|
|
Service Code
|
MSDRG 294
|
| Min. Negotiated Rate |
$9,861.81 |
| Max. Negotiated Rate |
$12,976.06 |
| Rate for Payer: Aetna Medicare |
$10,796.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,976.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,976.06
|
| Rate for Payer: BCBS MAPPO |
$10,380.85
|
| Rate for Payer: BCN Medicare Advantage |
$10,380.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,380.85
|
| Rate for Payer: Mclaren Medicare |
$10,380.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,899.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,937.98
|
| Rate for Payer: PACE Medicare |
$9,861.81
|
| Rate for Payer: PACE SWMI |
$10,380.85
|
| Rate for Payer: PHP Medicare Advantage |
$10,380.85
|
| Rate for Payer: Priority Health Medicare |
$10,380.85
|
| Rate for Payer: Railroad Medicare Medicare |
$10,380.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,380.85
|
| Rate for Payer: UHC Medicare Advantage |
$10,380.85
|
| Rate for Payer: VA VA |
$10,380.85
|
|
|
MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$8,542.27
|
|
|
Service Code
|
MSDRG 295
|
| Min. Negotiated Rate |
$6,492.13 |
| Max. Negotiated Rate |
$8,542.27 |
| Rate for Payer: Aetna Medicare |
$7,107.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,542.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,542.27
|
| Rate for Payer: BCBS MAPPO |
$6,833.82
|
| Rate for Payer: BCN Medicare Advantage |
$6,833.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,833.82
|
| Rate for Payer: Mclaren Medicare |
$6,833.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,175.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,858.89
|
| Rate for Payer: PACE Medicare |
$6,492.13
|
| Rate for Payer: PACE SWMI |
$6,833.82
|
| Rate for Payer: PHP Medicare Advantage |
$6,833.82
|
| Rate for Payer: Priority Health Medicare |
$6,833.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6,833.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,833.82
|
| Rate for Payer: UHC Medicare Advantage |
$6,833.82
|
| Rate for Payer: VA VA |
$6,833.82
|
|
|
MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC
|
Facility
|
IP
|
$25,887.95
|
|
|
Service Code
|
MSDRG 056
|
| Min. Negotiated Rate |
$19,674.84 |
| Max. Negotiated Rate |
$25,887.95 |
| Rate for Payer: Aetna Medicare |
$21,538.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,887.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,887.95
|
| Rate for Payer: BCBS MAPPO |
$20,710.36
|
| Rate for Payer: BCN Medicare Advantage |
$20,710.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,710.36
|
| Rate for Payer: Mclaren Medicare |
$20,710.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,745.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,816.91
|
| Rate for Payer: PACE Medicare |
$19,674.84
|
| Rate for Payer: PACE SWMI |
$20,710.36
|
| Rate for Payer: PHP Medicare Advantage |
$20,710.36
|
| Rate for Payer: Priority Health Medicare |
$20,710.36
|
| Rate for Payer: Railroad Medicare Medicare |
$20,710.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,710.36
|
| Rate for Payer: UHC Medicare Advantage |
$20,710.36
|
| Rate for Payer: VA VA |
$20,710.36
|
|
|
MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$14,052.65
|
|
|
Service Code
|
MSDRG 057
|
| Min. Negotiated Rate |
$10,680.01 |
| Max. Negotiated Rate |
$14,052.65 |
| Rate for Payer: Aetna Medicare |
$11,691.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,052.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,052.65
|
| Rate for Payer: BCBS MAPPO |
$11,242.12
|
| Rate for Payer: BCN Medicare Advantage |
$11,242.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,242.12
|
| Rate for Payer: Mclaren Medicare |
$11,242.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,804.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,928.44
|
| Rate for Payer: PACE Medicare |
$10,680.01
|
| Rate for Payer: PACE SWMI |
$11,242.12
|
| Rate for Payer: PHP Medicare Advantage |
$11,242.12
|
| Rate for Payer: Priority Health Medicare |
$11,242.12
|
| Rate for Payer: Railroad Medicare Medicare |
$11,242.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,242.12
|
| Rate for Payer: UHC Medicare Advantage |
$11,242.12
|
| Rate for Payer: VA VA |
$11,242.12
|
|
|
MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH CC
|
Facility
|
IP
|
$10,068.08
|
|
|
Service Code
|
MSDRG 158
|
| Min. Negotiated Rate |
$7,651.74 |
| Max. Negotiated Rate |
$10,068.08 |
| Rate for Payer: Aetna Medicare |
$8,376.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,068.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,068.08
|
| Rate for Payer: BCBS MAPPO |
$8,054.46
|
| Rate for Payer: BCN Medicare Advantage |
$8,054.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,054.46
|
| Rate for Payer: Mclaren Medicare |
$8,054.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,457.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,262.63
|
| Rate for Payer: PACE Medicare |
$7,651.74
|
| Rate for Payer: PACE SWMI |
$8,054.46
|
| Rate for Payer: PHP Medicare Advantage |
$8,054.46
|
| Rate for Payer: Priority Health Medicare |
$8,054.46
|
| Rate for Payer: Railroad Medicare Medicare |
$8,054.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,054.46
|
| Rate for Payer: UHC Medicare Advantage |
$8,054.46
|
| Rate for Payer: VA VA |
$8,054.46
|
|
|
MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH MCC
|
Facility
|
IP
|
$17,119.50
|
|
|
Service Code
|
MSDRG 157
|
| Min. Negotiated Rate |
$13,010.82 |
| Max. Negotiated Rate |
$17,119.50 |
| Rate for Payer: Aetna Medicare |
$14,243.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,119.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,119.50
|
| Rate for Payer: BCBS MAPPO |
$13,695.60
|
| Rate for Payer: BCN Medicare Advantage |
$13,695.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,695.60
|
| Rate for Payer: Mclaren Medicare |
$13,695.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,380.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,749.94
|
| Rate for Payer: PACE Medicare |
$13,010.82
|
| Rate for Payer: PACE SWMI |
$13,695.60
|
| Rate for Payer: PHP Medicare Advantage |
$13,695.60
|
| Rate for Payer: Priority Health Medicare |
$13,695.60
|
| Rate for Payer: Railroad Medicare Medicare |
$13,695.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,695.60
|
| Rate for Payer: UHC Medicare Advantage |
$13,695.60
|
| Rate for Payer: VA VA |
$13,695.60
|
|
|
MS-DRG 42.00: DENTAL AND ORAL DISEASES WITHOUT CC/MCC
|
Facility
|
IP
|
$7,224.85
|
|
|
Service Code
|
MSDRG 159
|
| Min. Negotiated Rate |
$5,490.89 |
| Max. Negotiated Rate |
$7,224.85 |
| Rate for Payer: Aetna Medicare |
$6,011.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,224.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,224.85
|
| Rate for Payer: BCBS MAPPO |
$5,779.88
|
| Rate for Payer: BCN Medicare Advantage |
$5,779.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,779.88
|
| Rate for Payer: Mclaren Medicare |
$5,779.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,068.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,646.86
|
| Rate for Payer: PACE Medicare |
$5,490.89
|
| Rate for Payer: PACE SWMI |
$5,779.88
|
| Rate for Payer: PHP Medicare Advantage |
$5,779.88
|
| Rate for Payer: Priority Health Medicare |
$5,779.88
|
| Rate for Payer: Railroad Medicare Medicare |
$5,779.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,779.88
|
| Rate for Payer: UHC Medicare Advantage |
$5,779.88
|
| Rate for Payer: VA VA |
$5,779.88
|
|
|
MS-DRG 42.00: DEPRESSIVE NEUROSES
|
Facility
|
IP
|
$9,799.95
|
|
|
Service Code
|
MSDRG 881
|
| Min. Negotiated Rate |
$7,447.96 |
| Max. Negotiated Rate |
$9,799.95 |
| Rate for Payer: Aetna Medicare |
$8,153.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,799.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,799.95
|
| Rate for Payer: BCBS MAPPO |
$7,839.96
|
| Rate for Payer: BCN Medicare Advantage |
$7,839.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,839.96
|
| Rate for Payer: Mclaren Medicare |
$7,839.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,231.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,015.95
|
| Rate for Payer: PACE Medicare |
$7,447.96
|
| Rate for Payer: PACE SWMI |
$7,839.96
|
| Rate for Payer: PHP Medicare Advantage |
$7,839.96
|
| Rate for Payer: Priority Health Medicare |
$7,839.96
|
| Rate for Payer: Railroad Medicare Medicare |
$7,839.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,839.96
|
| Rate for Payer: UHC Medicare Advantage |
$7,839.96
|
| Rate for Payer: VA VA |
$7,839.96
|
|
|
MS-DRG 42.00: DIABETES WITH CC
|
Facility
|
IP
|
$9,831.31
|
|
|
Service Code
|
MSDRG 638
|
| Min. Negotiated Rate |
$7,471.80 |
| Max. Negotiated Rate |
$9,831.31 |
| Rate for Payer: Aetna Medicare |
$8,179.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,831.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,831.31
|
| Rate for Payer: BCBS MAPPO |
$7,865.05
|
| Rate for Payer: BCN Medicare Advantage |
$7,865.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,865.05
|
| Rate for Payer: Mclaren Medicare |
$7,865.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,258.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,044.81
|
| Rate for Payer: PACE Medicare |
$7,471.80
|
| Rate for Payer: PACE SWMI |
$7,865.05
|
| Rate for Payer: PHP Medicare Advantage |
$7,865.05
|
| Rate for Payer: Priority Health Medicare |
$7,865.05
|
| Rate for Payer: Railroad Medicare Medicare |
$7,865.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,865.05
|
| Rate for Payer: UHC Medicare Advantage |
$7,865.05
|
| Rate for Payer: VA VA |
$7,865.05
|
|
|
MS-DRG 42.00: DIABETES WITH MCC
|
Facility
|
IP
|
$15,286.06
|
|
|
Service Code
|
MSDRG 637
|
| Min. Negotiated Rate |
$11,617.41 |
| Max. Negotiated Rate |
$15,286.06 |
| Rate for Payer: Aetna Medicare |
$12,718.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,286.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,286.06
|
| Rate for Payer: BCBS MAPPO |
$12,228.85
|
| Rate for Payer: BCN Medicare Advantage |
$12,228.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,228.85
|
| Rate for Payer: Mclaren Medicare |
$12,228.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,840.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,063.18
|
| Rate for Payer: PACE Medicare |
$11,617.41
|
| Rate for Payer: PACE SWMI |
$12,228.85
|
| Rate for Payer: PHP Medicare Advantage |
$12,228.85
|
| Rate for Payer: Priority Health Medicare |
$12,228.85
|
| Rate for Payer: Railroad Medicare Medicare |
$12,228.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,228.85
|
| Rate for Payer: UHC Medicare Advantage |
$12,228.85
|
| Rate for Payer: VA VA |
$12,228.85
|
|
|
MS-DRG 42.00: DIABETES WITHOUT CC/MCC
|
Facility
|
IP
|
$6,890.96
|
|
|
Service Code
|
MSDRG 639
|
| Min. Negotiated Rate |
$5,237.13 |
| Max. Negotiated Rate |
$6,890.96 |
| Rate for Payer: Aetna Medicare |
$5,733.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,890.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,890.96
|
| Rate for Payer: BCBS MAPPO |
$5,512.77
|
| Rate for Payer: BCN Medicare Advantage |
$5,512.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,512.77
|
| Rate for Payer: Mclaren Medicare |
$5,512.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,788.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,339.69
|
| Rate for Payer: PACE Medicare |
$5,237.13
|
| Rate for Payer: PACE SWMI |
$5,512.77
|
| Rate for Payer: PHP Medicare Advantage |
$5,512.77
|
| Rate for Payer: Priority Health Medicare |
$5,512.77
|
| Rate for Payer: Railroad Medicare Medicare |
$5,512.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,512.77
|
| Rate for Payer: UHC Medicare Advantage |
$5,512.77
|
| Rate for Payer: VA VA |
$5,512.77
|
|
