|
PERITON.DIALYSIS SOLN 6-1.5 % DEXTROS LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
OP
|
$135.60
|
|
|
Service Code
|
NDC 49230020692
|
| Hospital Charge Code |
27796
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$50.17 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna American Axle |
$88.14
|
| Rate for Payer: Aetna Commercial |
$115.26
|
| Rate for Payer: Aetna Medicare |
$67.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.14
|
| Rate for Payer: BCBS Complete |
$54.24
|
| Rate for Payer: Cash Price |
$108.48
|
| Rate for Payer: Cofinity Advantage |
$94.92
|
| Rate for Payer: Cofinity Commercial |
$116.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.48
|
| Rate for Payer: Healthscope Commercial |
$122.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.70
|
| Rate for Payer: PHP Commercial |
$115.26
|
| Rate for Payer: Priority Health SBD |
$85.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.14
|
| Rate for Payer: UHC Core |
$70.65
|
| Rate for Payer: UHC Exchange |
$53.29
|
| Rate for Payer: UMR Bronson Commercial |
$50.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.70
|
|
|
PERITONEAL ADHESIOLYSIS
|
Facility
|
IP
|
$9,353.48
|
|
|
Service Code
|
APR-DRG 2241
|
| Min. Negotiated Rate |
$8,908.08 |
| Max. Negotiated Rate |
$9,353.48 |
| Rate for Payer: BCBS Complete |
$9,353.48
|
| Rate for Payer: Mclaren Medicaid |
$8,908.08
|
| Rate for Payer: Meridian Medicaid |
$9,353.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,908.08
|
| Rate for Payer: UHC Medicaid |
$8,908.08
|
| Rate for Payer: UHCCP Medicaid |
$8,908.08
|
|
|
PERITONEAL ADHESIOLYSIS
|
Facility
|
IP
|
$12,258.44
|
|
|
Service Code
|
APR-DRG 2242
|
| Min. Negotiated Rate |
$11,674.70 |
| Max. Negotiated Rate |
$12,258.44 |
| Rate for Payer: BCBS Complete |
$12,258.44
|
| Rate for Payer: Mclaren Medicaid |
$11,674.70
|
| Rate for Payer: Meridian Medicaid |
$12,258.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,674.70
|
| Rate for Payer: UHC Medicaid |
$11,674.70
|
| Rate for Payer: UHCCP Medicaid |
$11,674.70
|
|
|
PERITONEAL ADHESIOLYSIS
|
Facility
|
IP
|
$29,682.11
|
|
|
Service Code
|
APR-DRG 2244
|
| Min. Negotiated Rate |
$28,268.68 |
| Max. Negotiated Rate |
$29,682.11 |
| Rate for Payer: BCBS Complete |
$29,682.11
|
| Rate for Payer: Mclaren Medicaid |
$28,268.68
|
| Rate for Payer: Meridian Medicaid |
$29,682.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$28,268.68
|
| Rate for Payer: UHC Medicaid |
$28,268.68
|
| Rate for Payer: UHCCP Medicaid |
$28,268.68
|
|
|
PERITONEAL ADHESIOLYSIS
|
Facility
|
IP
|
$15,889.18
|
|
|
Service Code
|
APR-DRG 2243
|
| Min. Negotiated Rate |
$15,132.55 |
| Max. Negotiated Rate |
$15,889.18 |
| Rate for Payer: BCBS Complete |
$15,889.18
|
| Rate for Payer: Mclaren Medicaid |
$15,132.55
|
| Rate for Payer: Meridian Medicaid |
$15,889.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,132.55
|
| Rate for Payer: UHC Medicaid |
$15,132.55
|
| Rate for Payer: UHCCP Medicaid |
$15,132.55
|
|
|
PERITONEAL ADHESIOLYSIS WITH CC
|
Facility
|
IP
|
$41,813.36
|
|
|
Service Code
|
MSDRG 336
|
| Min. Negotiated Rate |
$17,316.02 |
| Max. Negotiated Rate |
$41,813.36 |
| Rate for Payer: Aetna Medicare |
$18,956.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,784.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,784.24
|
| Rate for Payer: BCBS MAPPO |
$18,227.39
|
| Rate for Payer: BCBS Trust/PPO |
$41,813.36
|
| Rate for Payer: BCN Commercial |
$41,813.36
|
| Rate for Payer: BCN Medicare Advantage |
$18,227.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,227.39
|
| Rate for Payer: Mclaren Medicare |
$18,227.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,138.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,961.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,050.13
|
| Rate for Payer: Nomi Health Commercial |
$27,202.23
|
| Rate for Payer: PACE Medicare |
$17,316.02
|
| Rate for Payer: PACE SWMI |
$18,227.39
|
| Rate for Payer: PHP Medicare Advantage |
$18,227.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33,996.76
|
| Rate for Payer: Priority Health Medicare |
$18,227.39
|
| Rate for Payer: Priority Health Tiered Network |
$27,197.40
|
| Rate for Payer: Railroad Medicare Medicare |
$18,227.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,371.81
|
| Rate for Payer: UHC Core |
$28,756.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,227.39
|
| Rate for Payer: UHC Exchange |
$23,484.59
|
| Rate for Payer: VA VA |
$18,227.39
|
|
|
PERITONEAL ADHESIOLYSIS WITH MCC
|
Facility
|
IP
|
$64,504.36
|
|
|
Service Code
|
MSDRG 335
|
| Min. Negotiated Rate |
$28,932.54 |
| Max. Negotiated Rate |
$64,504.36 |
| Rate for Payer: Aetna Medicare |
$31,673.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,069.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,069.14
|
| Rate for Payer: BCBS MAPPO |
$30,455.31
|
| Rate for Payer: BCBS Trust/PPO |
$64,504.36
|
| Rate for Payer: BCN Commercial |
$64,504.36
|
| Rate for Payer: BCN Medicare Advantage |
$30,455.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,455.31
|
| Rate for Payer: Mclaren Medicare |
$30,455.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,978.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,023.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$33,500.84
|
| Rate for Payer: Nomi Health Commercial |
$46,064.61
|
| Rate for Payer: PACE Medicare |
$28,932.54
|
| Rate for Payer: PACE SWMI |
$30,455.31
|
| Rate for Payer: PHP Medicare Advantage |
$30,455.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57,570.55
|
| Rate for Payer: Priority Health Medicare |
$30,455.31
|
| Rate for Payer: Priority Health Tiered Network |
$46,056.43
|
| Rate for Payer: Railroad Medicare Medicare |
$30,455.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,205.67
|
| Rate for Payer: UHC Core |
$48,696.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30,455.31
|
| Rate for Payer: UHC Exchange |
$39,769.11
|
| Rate for Payer: VA VA |
$30,455.31
|
|
|
PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$35,691.79
|
|
|
Service Code
|
MSDRG 337
|
| Min. Negotiated Rate |
$12,758.22 |
| Max. Negotiated Rate |
$35,691.79 |
| Rate for Payer: Aetna Medicare |
$13,966.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,787.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,787.14
|
| Rate for Payer: BCBS MAPPO |
$13,429.71
|
| Rate for Payer: BCBS Trust/PPO |
$35,691.79
|
| Rate for Payer: BCN Commercial |
$35,691.79
|
| Rate for Payer: BCN Medicare Advantage |
$13,429.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,429.71
|
| Rate for Payer: Mclaren Medicare |
$13,429.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,101.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,444.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,772.68
|
| Rate for Payer: Nomi Health Commercial |
$19,801.50
|
| Rate for Payer: PACE Medicare |
$12,758.22
|
| Rate for Payer: PACE SWMI |
$13,429.71
|
| Rate for Payer: PHP Medicare Advantage |
$13,429.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,747.48
|
| Rate for Payer: Priority Health Medicare |
$13,429.71
|
| Rate for Payer: Priority Health Tiered Network |
$19,797.98
|
| Rate for Payer: Railroad Medicare Medicare |
$13,429.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,020.50
|
| Rate for Payer: UHC Core |
$20,932.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,429.71
|
| Rate for Payer: UHC Exchange |
$17,095.29
|
| Rate for Payer: VA VA |
$13,429.71
|
|
|
PERITONEAL DIALYSIS DRAINAGE BAG (EMPTY BAG)
|
Facility
|
IP
|
$13.51
|
|
|
Service Code
|
NDC 09900001008
|
| Hospital Charge Code |
200025
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$12.16 |
| Rate for Payer: Aetna American Axle |
$8.78
|
| Rate for Payer: Aetna Commercial |
$11.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: Cash Price |
$10.81
|
| Rate for Payer: Cofinity Advantage |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$11.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.81
|
| Rate for Payer: Healthscope Commercial |
$12.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.13
|
| Rate for Payer: PHP Commercial |
$11.48
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: UMR Bronson Commercial |
$5.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.13
|
|
|
PERITONEAL DIALYSIS DRAINAGE BAG (EMPTY BAG)
|
Facility
|
OP
|
$13.51
|
|
|
Service Code
|
NDC 09900001008
|
| Hospital Charge Code |
200025
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$12.16 |
| Rate for Payer: Aetna American Axle |
$8.78
|
| Rate for Payer: Aetna Commercial |
$11.48
|
| Rate for Payer: Aetna Medicare |
$6.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: BCBS Complete |
$5.40
|
| Rate for Payer: Cash Price |
$10.81
|
| Rate for Payer: Cofinity Advantage |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$11.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.81
|
| Rate for Payer: Healthscope Commercial |
$12.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.13
|
| Rate for Payer: PHP Commercial |
$11.48
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.78
|
| Rate for Payer: UHC Core |
$7.04
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UMR Bronson Commercial |
$5.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.13
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
OP
|
$135.60
|
|
|
Service Code
|
NDC 49230020992
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$50.17 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna American Axle |
$88.14
|
| Rate for Payer: Aetna Commercial |
$115.26
|
| Rate for Payer: Aetna Medicare |
$67.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.14
|
| Rate for Payer: BCBS Complete |
$54.24
|
| Rate for Payer: Cash Price |
$108.48
|
| Rate for Payer: Cofinity Advantage |
$94.92
|
| Rate for Payer: Cofinity Commercial |
$116.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.48
|
| Rate for Payer: Healthscope Commercial |
$122.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.70
|
| Rate for Payer: PHP Commercial |
$115.26
|
| Rate for Payer: Priority Health SBD |
$85.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.14
|
| Rate for Payer: UHC Core |
$70.65
|
| Rate for Payer: UHC Exchange |
$53.29
|
| Rate for Payer: UMR Bronson Commercial |
$50.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.70
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
OP
|
$118.65
|
|
|
Service Code
|
NDC 49230020994
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$43.90 |
| Max. Negotiated Rate |
$106.78 |
| Rate for Payer: Aetna American Axle |
$77.12
|
| Rate for Payer: Aetna Commercial |
$100.85
|
| Rate for Payer: Aetna Medicare |
$59.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.12
|
| Rate for Payer: BCBS Complete |
$47.46
|
| Rate for Payer: Cash Price |
$94.92
|
| Rate for Payer: Cofinity Advantage |
$83.06
|
| Rate for Payer: Cofinity Commercial |
$102.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.92
|
| Rate for Payer: Healthscope Commercial |
$106.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.99
|
| Rate for Payer: PHP Commercial |
$100.85
|
| Rate for Payer: Priority Health SBD |
$74.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.12
|
| Rate for Payer: UHC Core |
$61.82
|
| Rate for Payer: UHC Exchange |
$46.63
|
| Rate for Payer: UMR Bronson Commercial |
$43.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.99
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
IP
|
$135.60
|
|
|
Service Code
|
NDC 49230020992
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$59.66 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna American Axle |
$88.14
|
| Rate for Payer: Aetna Commercial |
$115.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.14
|
| Rate for Payer: Cash Price |
$108.48
|
| Rate for Payer: Cofinity Advantage |
$94.92
|
| Rate for Payer: Cofinity Commercial |
$116.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.48
|
| Rate for Payer: Healthscope Commercial |
$122.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.70
|
| Rate for Payer: PHP Commercial |
$115.26
|
| Rate for Payer: Priority Health SBD |
$85.43
|
| Rate for Payer: UMR Bronson Commercial |
$59.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.70
|
|
|
PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
|
Facility
|
IP
|
$118.65
|
|
|
Service Code
|
NDC 49230020994
|
| Hospital Charge Code |
27800
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$52.21 |
| Max. Negotiated Rate |
$106.78 |
| Rate for Payer: Aetna American Axle |
$77.12
|
| Rate for Payer: Aetna Commercial |
$100.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.12
|
| Rate for Payer: Cash Price |
$94.92
|
| Rate for Payer: Cofinity Advantage |
$83.06
|
| Rate for Payer: Cofinity Commercial |
$102.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.92
|
| Rate for Payer: Healthscope Commercial |
$106.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.99
|
| Rate for Payer: PHP Commercial |
$100.85
|
| Rate for Payer: Priority Health SBD |
$74.75
|
| Rate for Payer: UMR Bronson Commercial |
$52.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.99
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$42,528.92
|
|
|
Service Code
|
APR-DRG 1704
|
| Min. Negotiated Rate |
$40,503.74 |
| Max. Negotiated Rate |
$42,528.92 |
| Rate for Payer: BCBS Complete |
$42,528.92
|
| Rate for Payer: Mclaren Medicaid |
$40,503.74
|
| Rate for Payer: Meridian Medicaid |
$42,528.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$40,503.74
|
| Rate for Payer: UHC Medicaid |
$40,503.74
|
| Rate for Payer: UHCCP Medicaid |
$40,503.74
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$25,777.77
|
|
|
Service Code
|
APR-DRG 1703
|
| Min. Negotiated Rate |
$24,550.25 |
| Max. Negotiated Rate |
$25,777.77 |
| Rate for Payer: BCBS Complete |
$25,777.77
|
| Rate for Payer: Mclaren Medicaid |
$24,550.25
|
| Rate for Payer: Meridian Medicaid |
$25,777.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$24,550.25
|
| Rate for Payer: UHC Medicaid |
$24,550.25
|
| Rate for Payer: UHCCP Medicaid |
$24,550.25
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$17,742.08
|
|
|
Service Code
|
APR-DRG 1702
|
| Min. Negotiated Rate |
$16,897.22 |
| Max. Negotiated Rate |
$17,742.08 |
| Rate for Payer: BCBS Complete |
$17,742.08
|
| Rate for Payer: Mclaren Medicaid |
$16,897.22
|
| Rate for Payer: Meridian Medicaid |
$17,742.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,897.22
|
| Rate for Payer: UHC Medicaid |
$16,897.22
|
| Rate for Payer: UHCCP Medicaid |
$16,897.22
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$13,141.61
|
|
|
Service Code
|
APR-DRG 1701
|
| Min. Negotiated Rate |
$12,515.82 |
| Max. Negotiated Rate |
$13,141.61 |
| Rate for Payer: BCBS Complete |
$13,141.61
|
| Rate for Payer: Mclaren Medicaid |
$12,515.82
|
| Rate for Payer: Meridian Medicaid |
$13,141.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,515.82
|
| Rate for Payer: UHC Medicaid |
$12,515.82
|
| Rate for Payer: UHCCP Medicaid |
$12,515.82
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC
|
Facility
|
IP
|
$48,706.31
|
|
|
Service Code
|
MSDRG 243
|
| Min. Negotiated Rate |
$17,492.39 |
| Max. Negotiated Rate |
$48,706.31 |
| Rate for Payer: Aetna Medicare |
$19,149.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,016.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,016.30
|
| Rate for Payer: BCBS MAPPO |
$18,413.04
|
| Rate for Payer: BCBS Trust/PPO |
$48,706.31
|
| Rate for Payer: BCN Commercial |
$48,706.31
|
| Rate for Payer: BCN Medicare Advantage |
$18,413.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,413.04
|
| Rate for Payer: Mclaren Medicare |
$18,413.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,333.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,175.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,254.34
|
| Rate for Payer: Nomi Health Commercial |
$27,488.61
|
| Rate for Payer: PACE Medicare |
$17,492.39
|
| Rate for Payer: PACE SWMI |
$18,413.04
|
| Rate for Payer: PHP Medicare Advantage |
$18,413.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34,354.67
|
| Rate for Payer: Priority Health Medicare |
$18,413.04
|
| Rate for Payer: Priority Health Tiered Network |
$27,483.73
|
| Rate for Payer: Railroad Medicare Medicare |
$18,413.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,733.67
|
| Rate for Payer: UHC Core |
$29,059.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,413.04
|
| Rate for Payer: UHC Exchange |
$23,731.83
|
| Rate for Payer: VA VA |
$18,413.04
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC
|
Facility
|
IP
|
$73,296.92
|
|
|
Service Code
|
MSDRG 242
|
| Min. Negotiated Rate |
$25,928.72 |
| Max. Negotiated Rate |
$73,296.92 |
| Rate for Payer: Aetna Medicare |
$28,385.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,116.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,116.74
|
| Rate for Payer: BCBS MAPPO |
$27,293.39
|
| Rate for Payer: BCBS Trust/PPO |
$73,296.92
|
| Rate for Payer: BCN Commercial |
$73,296.92
|
| Rate for Payer: BCN Medicare Advantage |
$27,293.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,293.39
|
| Rate for Payer: Mclaren Medicare |
$27,293.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,658.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,387.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$30,022.73
|
| Rate for Payer: Nomi Health Commercial |
$41,187.12
|
| Rate for Payer: PACE Medicare |
$25,928.72
|
| Rate for Payer: PACE SWMI |
$27,293.39
|
| Rate for Payer: PHP Medicare Advantage |
$27,293.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51,474.77
|
| Rate for Payer: Priority Health Medicare |
$27,293.39
|
| Rate for Payer: Priority Health Tiered Network |
$41,179.81
|
| Rate for Payer: Railroad Medicare Medicare |
$27,293.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52,042.64
|
| Rate for Payer: UHC Core |
$43,540.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27,293.39
|
| Rate for Payer: UHC Exchange |
$35,558.21
|
| Rate for Payer: VA VA |
$27,293.39
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$18,328.64
|
|
|
Service Code
|
APR-DRG 1713
|
| Min. Negotiated Rate |
$17,455.84 |
| Max. Negotiated Rate |
$18,328.64 |
| Rate for Payer: BCBS Complete |
$18,328.64
|
| Rate for Payer: Mclaren Medicaid |
$17,455.84
|
| Rate for Payer: Meridian Medicaid |
$18,328.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,455.84
|
| Rate for Payer: UHC Medicaid |
$17,455.84
|
| Rate for Payer: UHCCP Medicaid |
$17,455.84
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$13,337.73
|
|
|
Service Code
|
APR-DRG 1712
|
| Min. Negotiated Rate |
$12,702.60 |
| Max. Negotiated Rate |
$13,337.73 |
| Rate for Payer: BCBS Complete |
$13,337.73
|
| Rate for Payer: Mclaren Medicaid |
$12,702.60
|
| Rate for Payer: Meridian Medicaid |
$13,337.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,702.60
|
| Rate for Payer: UHC Medicaid |
$12,702.60
|
| Rate for Payer: UHCCP Medicaid |
$12,702.60
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$10,286.89
|
|
|
Service Code
|
APR-DRG 1711
|
| Min. Negotiated Rate |
$9,797.04 |
| Max. Negotiated Rate |
$10,286.89 |
| Rate for Payer: BCBS Complete |
$10,286.89
|
| Rate for Payer: Mclaren Medicaid |
$9,797.04
|
| Rate for Payer: Meridian Medicaid |
$10,286.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,797.04
|
| Rate for Payer: UHC Medicaid |
$9,797.04
|
| Rate for Payer: UHCCP Medicaid |
$9,797.04
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK
|
Facility
|
IP
|
$26,240.84
|
|
|
Service Code
|
APR-DRG 1714
|
| Min. Negotiated Rate |
$24,991.28 |
| Max. Negotiated Rate |
$26,240.84 |
| Rate for Payer: BCBS Complete |
$26,240.84
|
| Rate for Payer: Mclaren Medicaid |
$24,991.28
|
| Rate for Payer: Meridian Medicaid |
$26,240.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$24,991.28
|
| Rate for Payer: UHC Medicaid |
$24,991.28
|
| Rate for Payer: UHCCP Medicaid |
$24,991.28
|
|
|
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$45,461.60
|
|
|
Service Code
|
MSDRG 244
|
| Min. Negotiated Rate |
$14,923.12 |
| Max. Negotiated Rate |
$45,461.60 |
| Rate for Payer: Aetna Medicare |
$16,336.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,635.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,635.69
|
| Rate for Payer: BCBS MAPPO |
$15,708.55
|
| Rate for Payer: BCBS Trust/PPO |
$45,461.60
|
| Rate for Payer: BCN Commercial |
$45,461.60
|
| Rate for Payer: BCN Medicare Advantage |
$15,708.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,708.55
|
| Rate for Payer: Mclaren Medicare |
$15,708.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,493.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,064.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,279.40
|
| Rate for Payer: Nomi Health Commercial |
$23,316.75
|
| Rate for Payer: PACE Medicare |
$14,923.12
|
| Rate for Payer: PACE SWMI |
$15,708.55
|
| Rate for Payer: PHP Medicare Advantage |
$15,708.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29,140.77
|
| Rate for Payer: Priority Health Medicare |
$15,708.55
|
| Rate for Payer: Priority Health Tiered Network |
$23,312.61
|
| Rate for Payer: Railroad Medicare Medicare |
$15,708.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,462.25
|
| Rate for Payer: UHC Core |
$24,648.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,708.55
|
| Rate for Payer: UHC Exchange |
$20,130.13
|
| Rate for Payer: VA VA |
$15,708.55
|
|
