|
MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$26,600.63
|
|
|
Service Code
|
MS-DRG 141
|
| Min. Negotiated Rate |
$18,259.72 |
| Max. Negotiated Rate |
$26,600.63 |
| Rate for Payer: Aetna Medicare |
$19,220.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,025.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,025.95
|
| Rate for Payer: BCBS MAPPO |
$19,220.76
|
| Rate for Payer: BCN Medicare Advantage |
$19,220.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,220.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,220.76
|
| Rate for Payer: Mclaren Medicare |
$19,220.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20,181.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,103.87
|
| Rate for Payer: PACE Medicare |
$18,259.72
|
| Rate for Payer: PACE SWMI |
$19,220.76
|
| Rate for Payer: PHP Commercial |
$21,142.84
|
| Rate for Payer: PHP Medicare Advantage |
$19,220.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,600.63
|
| Rate for Payer: Priority Health Medicare |
$19,220.76
|
| Rate for Payer: Priority Health Narrow Network |
$21,280.50
|
| Rate for Payer: Railroad Medicare Medicare |
$19,220.76
|
| Rate for Payer: UHC Medicare Advantage |
$19,797.38
|
| Rate for Payer: VA VA |
$19,220.76
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$48,510.80
|
|
|
Service Code
|
MS-DRG 140
|
| Min. Negotiated Rate |
$31,984.44 |
| Max. Negotiated Rate |
$48,510.80 |
| Rate for Payer: Aetna Medicare |
$33,667.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42,084.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42,084.79
|
| Rate for Payer: BCBS MAPPO |
$33,667.83
|
| Rate for Payer: BCN Medicare Advantage |
$33,667.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33,667.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$33,667.83
|
| Rate for Payer: Mclaren Medicare |
$33,667.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35,351.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38,718.00
|
| Rate for Payer: PACE Medicare |
$31,984.44
|
| Rate for Payer: PACE SWMI |
$33,667.83
|
| Rate for Payer: PHP Commercial |
$37,034.61
|
| Rate for Payer: PHP Medicare Advantage |
$33,667.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48,510.80
|
| Rate for Payer: Priority Health Medicare |
$33,667.83
|
| Rate for Payer: Priority Health Narrow Network |
$38,808.64
|
| Rate for Payer: Railroad Medicare Medicare |
$33,667.83
|
| Rate for Payer: UHC Medicare Advantage |
$34,677.86
|
| Rate for Payer: VA VA |
$33,667.83
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,837.80
|
|
|
Service Code
|
MS-DRG 142
|
| Min. Negotiated Rate |
$14,023.45 |
| Max. Negotiated Rate |
$19,837.80 |
| Rate for Payer: Aetna Medicare |
$14,761.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,451.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,451.91
|
| Rate for Payer: BCBS MAPPO |
$14,761.53
|
| Rate for Payer: BCN Medicare Advantage |
$14,761.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,761.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,761.53
|
| Rate for Payer: Mclaren Medicare |
$14,761.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,499.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,975.76
|
| Rate for Payer: PACE Medicare |
$14,023.45
|
| Rate for Payer: PACE SWMI |
$14,761.53
|
| Rate for Payer: PHP Commercial |
$16,237.68
|
| Rate for Payer: PHP Medicare Advantage |
$14,761.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,837.80
|
| Rate for Payer: Priority Health Medicare |
$14,761.53
|
| Rate for Payer: Priority Health Narrow Network |
$15,870.24
|
| Rate for Payer: Railroad Medicare Medicare |
$14,761.53
|
| Rate for Payer: UHC Medicare Advantage |
$15,204.38
|
| Rate for Payer: VA VA |
$14,761.53
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
|
IP
|
$15,464.50
|
|
|
Service Code
|
MS-DRG 809
|
| Min. Negotiated Rate |
$11,283.97 |
| Max. Negotiated Rate |
$15,464.50 |
| Rate for Payer: Aetna Medicare |
$11,877.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,847.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,847.32
|
| Rate for Payer: BCBS MAPPO |
$11,877.86
|
| Rate for Payer: BCN Medicare Advantage |
$11,877.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,877.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,877.86
|
| Rate for Payer: Mclaren Medicare |
$11,877.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,471.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,659.54
|
| Rate for Payer: PACE Medicare |
$11,283.97
|
| Rate for Payer: PACE SWMI |
$11,877.86
|
| Rate for Payer: PHP Commercial |
$13,065.65
|
| Rate for Payer: PHP Medicare Advantage |
$11,877.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,464.50
|
| Rate for Payer: Priority Health Medicare |
$11,877.86
|
| Rate for Payer: Priority Health Narrow Network |
$12,371.60
|
| Rate for Payer: Railroad Medicare Medicare |
$11,877.86
|
| Rate for Payer: UHC Medicare Advantage |
$12,234.20
|
| Rate for Payer: VA VA |
$11,877.86
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
|
IP
|
$28,120.88
|
|
|
Service Code
|
MS-DRG 808
|
| Min. Negotiated Rate |
$19,212.03 |
| Max. Negotiated Rate |
$28,120.88 |
| Rate for Payer: Aetna Medicare |
$20,223.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,278.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,278.99
|
| Rate for Payer: BCBS MAPPO |
$20,223.19
|
| Rate for Payer: BCN Medicare Advantage |
$20,223.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,223.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,223.19
|
| Rate for Payer: Mclaren Medicare |
$20,223.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21,234.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,256.67
|
| Rate for Payer: PACE Medicare |
$19,212.03
|
| Rate for Payer: PACE SWMI |
$20,223.19
|
| Rate for Payer: PHP Commercial |
$22,245.51
|
| Rate for Payer: PHP Medicare Advantage |
$20,223.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,120.88
|
| Rate for Payer: Priority Health Medicare |
$20,223.19
|
| Rate for Payer: Priority Health Narrow Network |
$22,496.70
|
| Rate for Payer: Railroad Medicare Medicare |
$20,223.19
|
| Rate for Payer: UHC Medicare Advantage |
$20,829.89
|
| Rate for Payer: VA VA |
$20,223.19
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,897.78
|
|
|
Service Code
|
MS-DRG 810
|
| Min. Negotiated Rate |
$9,676.17 |
| Max. Negotiated Rate |
$12,897.78 |
| Rate for Payer: Aetna Medicare |
$10,185.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,731.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,731.80
|
| Rate for Payer: BCBS MAPPO |
$10,185.44
|
| Rate for Payer: BCN Medicare Advantage |
$10,185.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,185.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,185.44
|
| Rate for Payer: Mclaren Medicare |
$10,185.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,694.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,713.26
|
| Rate for Payer: PACE Medicare |
$9,676.17
|
| Rate for Payer: PACE SWMI |
$10,185.44
|
| Rate for Payer: PHP Commercial |
$11,203.98
|
| Rate for Payer: PHP Medicare Advantage |
$10,185.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,897.78
|
| Rate for Payer: Priority Health Medicare |
$10,185.44
|
| Rate for Payer: Priority Health Narrow Network |
$10,318.22
|
| Rate for Payer: Railroad Medicare Medicare |
$10,185.44
|
| Rate for Payer: UHC Medicare Advantage |
$10,491.00
|
| Rate for Payer: VA VA |
$10,185.44
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$42,754.63
|
|
|
Service Code
|
MS-DRG 469
|
| Min. Negotiated Rate |
$28,378.73 |
| Max. Negotiated Rate |
$42,754.63 |
| Rate for Payer: Aetna Medicare |
$29,872.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,340.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,340.44
|
| Rate for Payer: BCBS MAPPO |
$29,872.35
|
| Rate for Payer: BCN Medicare Advantage |
$29,872.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,872.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$29,872.35
|
| Rate for Payer: Mclaren Medicare |
$29,872.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31,365.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,353.20
|
| Rate for Payer: PACE Medicare |
$28,378.73
|
| Rate for Payer: PACE SWMI |
$29,872.35
|
| Rate for Payer: PHP Commercial |
$32,859.58
|
| Rate for Payer: PHP Medicare Advantage |
$29,872.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42,754.63
|
| Rate for Payer: Priority Health Medicare |
$29,872.35
|
| Rate for Payer: Priority Health Narrow Network |
$34,203.70
|
| Rate for Payer: Railroad Medicare Medicare |
$29,872.35
|
| Rate for Payer: UHC Medicare Advantage |
$30,768.52
|
| Rate for Payer: VA VA |
$29,872.35
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$24,161.03
|
|
|
Service Code
|
MS-DRG 470
|
| Min. Negotiated Rate |
$16,731.54 |
| Max. Negotiated Rate |
$24,161.03 |
| Rate for Payer: Aetna Medicare |
$17,612.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,015.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,015.19
|
| Rate for Payer: BCBS MAPPO |
$17,612.15
|
| Rate for Payer: BCN Medicare Advantage |
$17,612.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,612.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,612.15
|
| Rate for Payer: Mclaren Medicare |
$17,612.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,492.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,253.97
|
| Rate for Payer: PACE Medicare |
$16,731.54
|
| Rate for Payer: PACE SWMI |
$17,612.15
|
| Rate for Payer: PHP Commercial |
$19,373.36
|
| Rate for Payer: PHP Medicare Advantage |
$17,612.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,161.03
|
| Rate for Payer: Priority Health Medicare |
$17,612.15
|
| Rate for Payer: Priority Health Narrow Network |
$19,328.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17,612.15
|
| Rate for Payer: UHC Medicare Advantage |
$18,140.51
|
| Rate for Payer: VA VA |
$17,612.15
|
|
|
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$31,897.13
|
|
|
Service Code
|
MS-DRG 483
|
| Min. Negotiated Rate |
$21,577.50 |
| Max. Negotiated Rate |
$31,897.13 |
| Rate for Payer: Aetna Medicare |
$22,713.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,391.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,391.45
|
| Rate for Payer: BCBS MAPPO |
$22,713.16
|
| Rate for Payer: BCN Medicare Advantage |
$22,713.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,713.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,713.16
|
| Rate for Payer: Mclaren Medicare |
$22,713.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23,848.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,120.13
|
| Rate for Payer: PACE Medicare |
$21,577.50
|
| Rate for Payer: PACE SWMI |
$22,713.16
|
| Rate for Payer: PHP Commercial |
$24,984.48
|
| Rate for Payer: PHP Medicare Advantage |
$22,713.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31,897.13
|
| Rate for Payer: Priority Health Medicare |
$22,713.16
|
| Rate for Payer: Priority Health Narrow Network |
$25,517.70
|
| Rate for Payer: Railroad Medicare Medicare |
$22,713.16
|
| Rate for Payer: UHC Medicare Advantage |
$23,394.55
|
| Rate for Payer: VA VA |
$22,713.16
|
|
|
MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$25,190.80
|
|
|
Service Code
|
MS-DRG 707
|
| Min. Negotiated Rate |
$17,376.60 |
| Max. Negotiated Rate |
$25,190.80 |
| Rate for Payer: Aetna Medicare |
$18,291.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,863.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,863.95
|
| Rate for Payer: BCBS MAPPO |
$18,291.16
|
| Rate for Payer: BCN Medicare Advantage |
$18,291.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,291.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,291.16
|
| Rate for Payer: Mclaren Medicare |
$18,291.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19,205.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,034.83
|
| Rate for Payer: PACE Medicare |
$17,376.60
|
| Rate for Payer: PACE SWMI |
$18,291.16
|
| Rate for Payer: PHP Commercial |
$20,120.28
|
| Rate for Payer: PHP Medicare Advantage |
$18,291.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,190.80
|
| Rate for Payer: Priority Health Medicare |
$18,291.16
|
| Rate for Payer: Priority Health Narrow Network |
$20,152.64
|
| Rate for Payer: Railroad Medicare Medicare |
$18,291.16
|
| Rate for Payer: UHC Medicare Advantage |
$18,839.89
|
| Rate for Payer: VA VA |
$18,291.16
|
|
|
MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,727.14
|
|
|
Service Code
|
MS-DRG 708
|
| Min. Negotiated Rate |
$13,327.72 |
| Max. Negotiated Rate |
$18,727.14 |
| Rate for Payer: Aetna Medicare |
$14,029.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,536.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,536.48
|
| Rate for Payer: BCBS MAPPO |
$14,029.18
|
| Rate for Payer: BCN Medicare Advantage |
$14,029.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,029.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,029.18
|
| Rate for Payer: Mclaren Medicare |
$14,029.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,730.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,133.56
|
| Rate for Payer: PACE Medicare |
$13,327.72
|
| Rate for Payer: PACE SWMI |
$14,029.18
|
| Rate for Payer: PHP Commercial |
$15,432.10
|
| Rate for Payer: PHP Medicare Advantage |
$14,029.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,727.14
|
| Rate for Payer: Priority Health Medicare |
$14,029.18
|
| Rate for Payer: Priority Health Narrow Network |
$14,981.71
|
| Rate for Payer: Railroad Medicare Medicare |
$14,029.18
|
| Rate for Payer: UHC Medicare Advantage |
$14,450.06
|
| Rate for Payer: VA VA |
$14,029.18
|
|
|
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$27,371.03
|
|
|
Service Code
|
MS-DRG 507
|
| Min. Negotiated Rate |
$18,742.31 |
| Max. Negotiated Rate |
$27,371.03 |
| Rate for Payer: Aetna Medicare |
$19,728.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,660.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,660.94
|
| Rate for Payer: BCBS MAPPO |
$19,728.75
|
| Rate for Payer: BCN Medicare Advantage |
$19,728.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,728.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,728.75
|
| Rate for Payer: Mclaren Medicare |
$19,728.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20,715.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,688.06
|
| Rate for Payer: PACE Medicare |
$18,742.31
|
| Rate for Payer: PACE SWMI |
$19,728.75
|
| Rate for Payer: PHP Commercial |
$21,701.62
|
| Rate for Payer: PHP Medicare Advantage |
$19,728.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27,371.03
|
| Rate for Payer: Priority Health Medicare |
$19,728.75
|
| Rate for Payer: Priority Health Narrow Network |
$21,896.82
|
| Rate for Payer: Railroad Medicare Medicare |
$19,728.75
|
| Rate for Payer: UHC Medicare Advantage |
$20,320.61
|
| Rate for Payer: VA VA |
$19,728.75
|
|
|
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,412.56
|
|
|
Service Code
|
MS-DRG 508
|
| Min. Negotiated Rate |
$13,130.66 |
| Max. Negotiated Rate |
$18,412.56 |
| Rate for Payer: Aetna Medicare |
$13,821.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,277.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,277.19
|
| Rate for Payer: BCBS MAPPO |
$13,821.75
|
| Rate for Payer: BCN Medicare Advantage |
$13,821.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,821.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,821.75
|
| Rate for Payer: Mclaren Medicare |
$13,821.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,512.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,895.01
|
| Rate for Payer: PACE Medicare |
$13,130.66
|
| Rate for Payer: PACE SWMI |
$13,821.75
|
| Rate for Payer: PHP Commercial |
$15,203.92
|
| Rate for Payer: PHP Medicare Advantage |
$13,821.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,412.56
|
| Rate for Payer: Priority Health Medicare |
$13,821.75
|
| Rate for Payer: Priority Health Narrow Network |
$14,730.05
|
| Rate for Payer: Railroad Medicare Medicare |
$13,821.75
|
| Rate for Payer: UHC Medicare Advantage |
$14,236.40
|
| Rate for Payer: VA VA |
$13,821.75
|
|
|
MAJOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$27,927.00
|
|
|
Service Code
|
MS-DRG 595
|
| Min. Negotiated Rate |
$19,090.57 |
| Max. Negotiated Rate |
$27,927.00 |
| Rate for Payer: Aetna Medicare |
$20,095.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,119.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,119.18
|
| Rate for Payer: BCBS MAPPO |
$20,095.34
|
| Rate for Payer: BCN Medicare Advantage |
$20,095.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,095.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,095.34
|
| Rate for Payer: Mclaren Medicare |
$20,095.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21,100.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,109.64
|
| Rate for Payer: PACE Medicare |
$19,090.57
|
| Rate for Payer: PACE SWMI |
$20,095.34
|
| Rate for Payer: PHP Commercial |
$22,104.87
|
| Rate for Payer: PHP Medicare Advantage |
$20,095.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27,927.00
|
| Rate for Payer: Priority Health Medicare |
$20,095.34
|
| Rate for Payer: Priority Health Narrow Network |
$22,341.60
|
| Rate for Payer: Railroad Medicare Medicare |
$20,095.34
|
| Rate for Payer: UHC Medicare Advantage |
$20,698.20
|
| Rate for Payer: VA VA |
$20,095.34
|
|
|
MAJOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$12,955.56
|
|
|
Service Code
|
MS-DRG 596
|
| Min. Negotiated Rate |
$9,712.35 |
| Max. Negotiated Rate |
$12,955.56 |
| Rate for Payer: Aetna Medicare |
$10,223.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,779.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,779.41
|
| Rate for Payer: BCBS MAPPO |
$10,223.53
|
| Rate for Payer: BCN Medicare Advantage |
$10,223.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,223.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,223.53
|
| Rate for Payer: Mclaren Medicare |
$10,223.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,734.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,757.06
|
| Rate for Payer: PACE Medicare |
$9,712.35
|
| Rate for Payer: PACE SWMI |
$10,223.53
|
| Rate for Payer: PHP Commercial |
$11,245.88
|
| Rate for Payer: PHP Medicare Advantage |
$10,223.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,955.56
|
| Rate for Payer: Priority Health Medicare |
$10,223.53
|
| Rate for Payer: Priority Health Narrow Network |
$10,364.45
|
| Rate for Payer: Railroad Medicare Medicare |
$10,223.53
|
| Rate for Payer: UHC Medicare Advantage |
$10,530.24
|
| Rate for Payer: VA VA |
$10,223.53
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$30,457.76
|
|
|
Service Code
|
MS-DRG 330
|
| Min. Negotiated Rate |
$20,675.86 |
| Max. Negotiated Rate |
$30,457.76 |
| Rate for Payer: Aetna Medicare |
$21,764.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,205.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,205.08
|
| Rate for Payer: BCBS MAPPO |
$21,764.06
|
| Rate for Payer: BCN Medicare Advantage |
$21,764.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,764.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,764.06
|
| Rate for Payer: Mclaren Medicare |
$21,764.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,852.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,028.67
|
| Rate for Payer: PACE Medicare |
$20,675.86
|
| Rate for Payer: PACE SWMI |
$21,764.06
|
| Rate for Payer: PHP Commercial |
$23,940.47
|
| Rate for Payer: PHP Medicare Advantage |
$21,764.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,457.76
|
| Rate for Payer: Priority Health Medicare |
$21,764.06
|
| Rate for Payer: Priority Health Narrow Network |
$24,366.21
|
| Rate for Payer: Railroad Medicare Medicare |
$21,764.06
|
| Rate for Payer: UHC Medicare Advantage |
$22,416.98
|
| Rate for Payer: VA VA |
$21,764.06
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$57,995.71
|
|
|
Service Code
|
MS-DRG 329
|
| Min. Negotiated Rate |
$37,925.86 |
| Max. Negotiated Rate |
$57,995.71 |
| Rate for Payer: Aetna Medicare |
$39,921.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49,902.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49,902.45
|
| Rate for Payer: BCBS MAPPO |
$39,921.96
|
| Rate for Payer: BCN Medicare Advantage |
$39,921.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39,921.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$39,921.96
|
| Rate for Payer: Mclaren Medicare |
$39,921.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41,918.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45,910.25
|
| Rate for Payer: PACE Medicare |
$37,925.86
|
| Rate for Payer: PACE SWMI |
$39,921.96
|
| Rate for Payer: PHP Commercial |
$43,914.16
|
| Rate for Payer: PHP Medicare Advantage |
$39,921.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57,995.71
|
| Rate for Payer: Priority Health Medicare |
$39,921.96
|
| Rate for Payer: Priority Health Narrow Network |
$46,396.57
|
| Rate for Payer: Railroad Medicare Medicare |
$39,921.96
|
| Rate for Payer: UHC Medicare Advantage |
$41,119.62
|
| Rate for Payer: VA VA |
$39,921.96
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$21,468.48
|
|
|
Service Code
|
MS-DRG 331
|
| Min. Negotiated Rate |
$15,044.91 |
| Max. Negotiated Rate |
$21,468.48 |
| Rate for Payer: Aetna Medicare |
$15,836.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,795.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,795.94
|
| Rate for Payer: BCBS MAPPO |
$15,836.75
|
| Rate for Payer: BCN Medicare Advantage |
$15,836.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,836.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,836.75
|
| Rate for Payer: Mclaren Medicare |
$15,836.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,628.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,212.26
|
| Rate for Payer: PACE Medicare |
$15,044.91
|
| Rate for Payer: PACE SWMI |
$15,836.75
|
| Rate for Payer: PHP Commercial |
$17,420.42
|
| Rate for Payer: PHP Medicare Advantage |
$15,836.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,468.48
|
| Rate for Payer: Priority Health Medicare |
$15,836.75
|
| Rate for Payer: Priority Health Narrow Network |
$17,174.78
|
| Rate for Payer: Railroad Medicare Medicare |
$15,836.75
|
| Rate for Payer: UHC Medicare Advantage |
$16,311.85
|
| Rate for Payer: VA VA |
$15,836.75
|
|
|
MAJOR THUMB OR JOINT PROCEDURES
|
Facility
|
IP
|
$18,779.78
|
|
|
Service Code
|
MS-DRG 506
|
| Min. Negotiated Rate |
$13,360.70 |
| Max. Negotiated Rate |
$18,779.78 |
| Rate for Payer: Aetna Medicare |
$14,063.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,579.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,579.88
|
| Rate for Payer: BCBS MAPPO |
$14,063.90
|
| Rate for Payer: BCN Medicare Advantage |
$14,063.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,063.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,063.90
|
| Rate for Payer: Mclaren Medicare |
$14,063.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,767.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,173.48
|
| Rate for Payer: PACE Medicare |
$13,360.70
|
| Rate for Payer: PACE SWMI |
$14,063.90
|
| Rate for Payer: PHP Commercial |
$15,470.29
|
| Rate for Payer: PHP Medicare Advantage |
$14,063.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,779.78
|
| Rate for Payer: Priority Health Medicare |
$14,063.90
|
| Rate for Payer: Priority Health Narrow Network |
$15,023.82
|
| Rate for Payer: Railroad Medicare Medicare |
$14,063.90
|
| Rate for Payer: UHC Medicare Advantage |
$14,485.82
|
| Rate for Payer: VA VA |
$14,063.90
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$13,927.55
|
|
|
Service Code
|
MS-DRG 755
|
| Min. Negotiated Rate |
$10,321.22 |
| Max. Negotiated Rate |
$13,927.55 |
| Rate for Payer: Aetna Medicare |
$10,864.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,580.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,580.55
|
| Rate for Payer: BCBS MAPPO |
$10,864.44
|
| Rate for Payer: BCN Medicare Advantage |
$10,864.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,864.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,864.44
|
| Rate for Payer: Mclaren Medicare |
$10,864.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,407.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,494.11
|
| Rate for Payer: PACE Medicare |
$10,321.22
|
| Rate for Payer: PACE SWMI |
$10,864.44
|
| Rate for Payer: PHP Commercial |
$11,950.88
|
| Rate for Payer: PHP Medicare Advantage |
$10,864.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,927.55
|
| Rate for Payer: Priority Health Medicare |
$10,864.44
|
| Rate for Payer: Priority Health Narrow Network |
$11,142.04
|
| Rate for Payer: Railroad Medicare Medicare |
$10,864.44
|
| Rate for Payer: UHC Medicare Advantage |
$11,190.37
|
| Rate for Payer: VA VA |
$10,864.44
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$23,786.10
|
|
|
Service Code
|
MS-DRG 754
|
| Min. Negotiated Rate |
$16,496.70 |
| Max. Negotiated Rate |
$23,786.10 |
| Rate for Payer: Aetna Medicare |
$17,364.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,706.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,706.19
|
| Rate for Payer: BCBS MAPPO |
$17,364.95
|
| Rate for Payer: BCN Medicare Advantage |
$17,364.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,364.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,364.95
|
| Rate for Payer: Mclaren Medicare |
$17,364.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,233.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,969.69
|
| Rate for Payer: PACE Medicare |
$16,496.70
|
| Rate for Payer: PACE SWMI |
$17,364.95
|
| Rate for Payer: PHP Commercial |
$19,101.44
|
| Rate for Payer: PHP Medicare Advantage |
$17,364.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,786.10
|
| Rate for Payer: Priority Health Medicare |
$17,364.95
|
| Rate for Payer: Priority Health Narrow Network |
$19,028.88
|
| Rate for Payer: Railroad Medicare Medicare |
$17,364.95
|
| Rate for Payer: UHC Medicare Advantage |
$17,885.90
|
| Rate for Payer: VA VA |
$17,364.95
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$12,707.75
|
|
|
Service Code
|
MS-DRG 756
|
| Min. Negotiated Rate |
$9,557.12 |
| Max. Negotiated Rate |
$12,707.75 |
| Rate for Payer: Aetna Medicare |
$10,060.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,575.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,575.16
|
| Rate for Payer: BCBS MAPPO |
$10,060.13
|
| Rate for Payer: BCN Medicare Advantage |
$10,060.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,060.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,060.13
|
| Rate for Payer: Mclaren Medicare |
$10,060.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,563.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,569.15
|
| Rate for Payer: PACE Medicare |
$9,557.12
|
| Rate for Payer: PACE SWMI |
$10,060.13
|
| Rate for Payer: PHP Commercial |
$11,066.14
|
| Rate for Payer: PHP Medicare Advantage |
$10,060.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,707.75
|
| Rate for Payer: Priority Health Medicare |
$10,060.13
|
| Rate for Payer: Priority Health Narrow Network |
$10,166.20
|
| Rate for Payer: Railroad Medicare Medicare |
$10,060.13
|
| Rate for Payer: UHC Medicare Advantage |
$10,361.93
|
| Rate for Payer: VA VA |
$10,060.13
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$14,307.61
|
|
|
Service Code
|
MS-DRG 723
|
| Min. Negotiated Rate |
$10,559.29 |
| Max. Negotiated Rate |
$14,307.61 |
| Rate for Payer: Aetna Medicare |
$11,115.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,893.80
|
| Rate for Payer: BCBS MAPPO |
$11,115.04
|
| Rate for Payer: BCN Medicare Advantage |
$11,115.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,115.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,115.04
|
| Rate for Payer: Mclaren Medicare |
$11,115.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,670.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,782.30
|
| Rate for Payer: PACE Medicare |
$10,559.29
|
| Rate for Payer: PACE SWMI |
$11,115.04
|
| Rate for Payer: PHP Commercial |
$12,226.54
|
| Rate for Payer: PHP Medicare Advantage |
$11,115.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,307.61
|
| Rate for Payer: Priority Health Medicare |
$11,115.04
|
| Rate for Payer: Priority Health Narrow Network |
$11,446.09
|
| Rate for Payer: Railroad Medicare Medicare |
$11,115.04
|
| Rate for Payer: UHC Medicare Advantage |
$11,448.49
|
| Rate for Payer: VA VA |
$11,115.04
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$24,072.43
|
|
|
Service Code
|
MS-DRG 722
|
| Min. Negotiated Rate |
$16,676.06 |
| Max. Negotiated Rate |
$24,072.43 |
| Rate for Payer: Aetna Medicare |
$17,553.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,942.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,942.19
|
| Rate for Payer: BCBS MAPPO |
$17,553.75
|
| Rate for Payer: BCN Medicare Advantage |
$17,553.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,553.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,553.75
|
| Rate for Payer: Mclaren Medicare |
$17,553.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,431.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,186.81
|
| Rate for Payer: PACE Medicare |
$16,676.06
|
| Rate for Payer: PACE SWMI |
$17,553.75
|
| Rate for Payer: PHP Commercial |
$19,309.12
|
| Rate for Payer: PHP Medicare Advantage |
$17,553.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,072.43
|
| Rate for Payer: Priority Health Medicare |
$17,553.75
|
| Rate for Payer: Priority Health Narrow Network |
$19,257.94
|
| Rate for Payer: Railroad Medicare Medicare |
$17,553.75
|
| Rate for Payer: UHC Medicare Advantage |
$18,080.36
|
| Rate for Payer: VA VA |
$17,553.75
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$10,668.11
|
|
|
Service Code
|
MS-DRG 724
|
| Min. Negotiated Rate |
$8,107.77 |
| Max. Negotiated Rate |
$10,668.11 |
| Rate for Payer: Aetna Medicare |
$8,534.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,668.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,668.11
|
| Rate for Payer: BCBS MAPPO |
$8,534.49
|
| Rate for Payer: BCN Medicare Advantage |
$8,534.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,534.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,534.49
|
| Rate for Payer: Mclaren Medicare |
$8,534.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,961.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,814.66
|
| Rate for Payer: PACE Medicare |
$8,107.77
|
| Rate for Payer: PACE SWMI |
$8,534.49
|
| Rate for Payer: PHP Commercial |
$9,387.94
|
| Rate for Payer: PHP Medicare Advantage |
$8,534.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,393.98
|
| Rate for Payer: Priority Health Medicare |
$8,534.49
|
| Rate for Payer: Priority Health Narrow Network |
$8,315.18
|
| Rate for Payer: Railroad Medicare Medicare |
$8,534.49
|
| Rate for Payer: UHC Medicare Advantage |
$8,790.52
|
| Rate for Payer: VA VA |
$8,534.49
|
|
