| 
                        APR-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $9,725.90
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2272 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,262.76 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $9,725.90 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9,725.90
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,262.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $9,725.90
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $9,262.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,262.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,262.76
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $11,226.17
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2273 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10,691.59 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $11,226.17 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $11,226.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $10,691.59
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $11,226.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $10,691.59
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $10,691.59
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $10,691.59
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $7,966.96
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2271 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $7,587.58 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $7,966.96 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $7,966.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $7,587.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $7,966.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $7,587.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $7,587.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $7,587.58
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIP AND FEMUR FRACTURE REPAIR
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $12,209.11
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3083 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $11,627.72 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $12,209.11 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $12,209.11
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $11,627.72
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $12,209.11
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $11,627.72
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $11,627.72
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $11,627.72
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIP AND FEMUR FRACTURE REPAIR
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $7,553.09
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3081 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $7,193.42 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $7,553.09 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $7,553.09
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $7,193.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $7,553.09
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $7,193.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $7,193.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $7,193.42
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIP AND FEMUR FRACTURE REPAIR
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $9,725.90
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3082 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,262.76 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $9,725.90 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9,725.90
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,262.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $9,725.90
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $9,262.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,262.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,262.76
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIP AND FEMUR FRACTURE REPAIR
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $21,003.80
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3084 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $20,003.62 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $21,003.80 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $21,003.80
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $20,003.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $21,003.80
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $20,003.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $20,003.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $20,003.62
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MAJOR HIV RELATED CONDITION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $11,122.70
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8924 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10,593.05 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $11,122.70 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $11,122.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $10,593.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $11,122.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $10,593.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $10,593.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $10,593.05
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MAJOR HIV RELATED CONDITION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,310.94
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8921 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,153.28 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,310.94 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,310.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,153.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,310.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $3,153.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,153.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,153.28
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MAJOR HIV RELATED CONDITION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,138.68
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8922 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,941.60 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,138.68 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,138.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,941.60
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,138.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $3,941.60
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,941.60
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,941.60
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MAJOR HIV RELATED CONDITION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $6,828.82
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8923 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6,503.64 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $6,828.82 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6,828.82
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $6,503.64
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $6,828.82
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $6,503.64
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $6,503.64
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $6,503.64
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $8,587.76
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8903 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $8,178.82 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $8,587.76 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $8,587.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $8,178.82
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $8,587.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $8,178.82
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $8,178.82
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $8,178.82
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,552.55
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8901 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,335.76 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,552.55 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,552.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,335.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,552.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $4,335.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,335.76
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,335.76
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $13,709.38
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8904 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $13,056.55 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $13,709.38 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $13,709.38
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $13,056.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $13,709.38
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $13,056.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $13,056.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $13,056.55
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $6,414.95
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8902 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6,109.48 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $6,414.95 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6,414.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $6,109.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $6,414.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $6,109.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $6,109.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $6,109.48
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $6,208.02
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8933 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5,912.40 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $6,208.02 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6,208.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $5,912.40
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $6,208.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $5,912.40
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $5,912.40
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $5,912.40
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $10,346.70
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8934 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,854.00 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $10,346.70 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $10,346.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,854.00
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $10,346.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $9,854.00
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,854.00
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,854.00
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,880.01
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8931 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,695.25 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,880.01 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,880.01
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,695.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,880.01
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $3,695.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,695.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,695.25
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $5,483.75
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8932 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5,222.62 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $5,483.75 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $5,483.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $5,222.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $5,483.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $5,222.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $5,222.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $5,222.62
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,517.88
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8941 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,350.36 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,517.88 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,517.88
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,350.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,517.88
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $3,350.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,350.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,350.36
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $6,777.09
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8944 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6,454.37 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $6,777.09 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6,777.09
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $6,454.37
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $6,777.09
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $6,454.37
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $6,454.37
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $6,454.37
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,828.28
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8942 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,645.98 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,828.28 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,828.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,645.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,828.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $3,645.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,645.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,645.98
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,397.35
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8943 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,187.95 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,397.35 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,397.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,187.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,397.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $4,187.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,187.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,187.95
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HYPERTENSION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $9,984.57
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 1994 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,509.11 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $9,984.57 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9,984.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,509.11
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $9,984.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $9,509.11
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,509.11
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,509.11
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: HYPERTENSION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,828.28
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 1991 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,645.98 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,828.28 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,828.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,645.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,828.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Medicaid | 
                                            
                                                $3,645.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,645.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,645.98
                                             | 
                                         
                                    
                                
                             
                         
                     |