|
HH HC NEGATIVE PRESSURE WOUND THERAPY DISPOSAL < 50SQ CM
|
Facility
|
OP
|
$964.48
|
|
|
Service Code
|
CPT 97607
|
| Hospital Charge Code |
76100035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$964.48 |
| Rate for Payer: Aetna Commercial |
$868.03
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$935.55
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$795.21
|
| Rate for Payer: BCN Commercial |
$795.21
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$771.58
|
| Rate for Payer: Cash Price |
$771.58
|
| Rate for Payer: Cofinity Commercial |
$906.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$935.55
|
| Rate for Payer: Healthscope Whirlpool |
$964.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$868.03
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$819.81
|
| Rate for Payer: Nomi Health Commercial |
$790.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.36
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$845.08
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$676.10
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$848.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HH HC NEGATIVE PRESSURE WOUND THERAPY DISPOSAL < 50SQ CM
|
Facility
|
IP
|
$964.48
|
|
|
Service Code
|
CPT 97607
|
| Hospital Charge Code |
76100035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$723.36 |
| Max. Negotiated Rate |
$964.48 |
| Rate for Payer: Aetna Commercial |
$868.03
|
| Rate for Payer: ASR ASR |
$935.55
|
| Rate for Payer: BCBS Trust/PPO |
$792.03
|
| Rate for Payer: BCN Commercial |
$792.03
|
| Rate for Payer: Cash Price |
$771.58
|
| Rate for Payer: Cofinity Commercial |
$906.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.58
|
| Rate for Payer: Healthscope Commercial |
$935.55
|
| Rate for Payer: Healthscope Whirlpool |
$964.48
|
| Rate for Payer: Mclaren Commercial |
$868.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$819.81
|
| Rate for Payer: Nomi Health Commercial |
$790.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$848.74
|
|
|
HH HC NEGATIVE PRESSURE WOUND THERAPY DISPOSAL >50SQ CM
|
Facility
|
IP
|
$839.87
|
|
|
Service Code
|
CPT 97608
|
| Hospital Charge Code |
76100036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$629.90 |
| Max. Negotiated Rate |
$839.87 |
| Rate for Payer: Aetna Commercial |
$755.88
|
| Rate for Payer: ASR ASR |
$814.67
|
| Rate for Payer: BCBS Trust/PPO |
$689.70
|
| Rate for Payer: BCN Commercial |
$689.70
|
| Rate for Payer: Cash Price |
$671.90
|
| Rate for Payer: Cofinity Commercial |
$789.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$671.90
|
| Rate for Payer: Healthscope Commercial |
$814.67
|
| Rate for Payer: Healthscope Whirlpool |
$839.87
|
| Rate for Payer: Mclaren Commercial |
$755.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.89
|
| Rate for Payer: Nomi Health Commercial |
$688.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$739.09
|
|
|
HH HC NEGATIVE PRESSURE WOUND THERAPY DISPOSAL >50SQ CM
|
Facility
|
OP
|
$839.87
|
|
|
Service Code
|
CPT 97608
|
| Hospital Charge Code |
76100036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$839.87 |
| Rate for Payer: Aetna Commercial |
$755.88
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$814.67
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$692.47
|
| Rate for Payer: BCN Commercial |
$692.47
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$671.90
|
| Rate for Payer: Cash Price |
$671.90
|
| Rate for Payer: Cofinity Commercial |
$789.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$671.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$814.67
|
| Rate for Payer: Healthscope Whirlpool |
$839.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$755.88
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.89
|
| Rate for Payer: Nomi Health Commercial |
$688.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.90
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$735.89
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$588.75
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$739.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HH POUCH 2.5" CTF HOLL8331 EA
|
Facility
|
IP
|
$6.36
|
|
|
Service Code
|
HCPCS A5056
|
| Hospital Charge Code |
27000597
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$6.36 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: ASR ASR |
$6.17
|
| Rate for Payer: BCBS Trust/PPO |
$5.22
|
| Rate for Payer: BCN Commercial |
$5.22
|
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Cofinity Commercial |
$5.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.09
|
| Rate for Payer: Healthscope Commercial |
$6.17
|
| Rate for Payer: Healthscope Whirlpool |
$6.36
|
| Rate for Payer: Mclaren Commercial |
$5.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.41
|
| Rate for Payer: Nomi Health Commercial |
$5.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.60
|
|
|
HH POUCH 2.5" CTF HOLL8331 EA
|
Facility
|
OP
|
$6.36
|
|
|
Service Code
|
HCPCS A5056
|
| Hospital Charge Code |
27000597
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$6.36 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: Aetna Medicare |
$2.35
|
| Rate for Payer: ASR ASR |
$6.17
|
| Rate for Payer: BCBS Complete |
$2.54
|
| Rate for Payer: BCBS Trust/PPO |
$5.24
|
| Rate for Payer: BCN Commercial |
$5.24
|
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Cofinity Commercial |
$5.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.09
|
| Rate for Payer: Healthscope Commercial |
$6.17
|
| Rate for Payer: Healthscope Whirlpool |
$6.36
|
| Rate for Payer: Mclaren Commercial |
$5.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.41
|
| Rate for Payer: Nomi Health Commercial |
$5.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5.57
|
| Rate for Payer: Priority Health Narrow Network |
$4.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.60
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$10,260.32
|
|
|
Service Code
|
APR-DRG 3082
|
| Min. Negotiated Rate |
$9,276.56 |
| Max. Negotiated Rate |
$10,260.32 |
| Rate for Payer: BCBS Complete |
$10,260.32
|
| Rate for Payer: Mclaren Medicaid |
$9,771.73
|
| Rate for Payer: Meridian Medicaid |
$10,260.32
|
| Rate for Payer: PHP Medicaid |
$9,276.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,771.73
|
| Rate for Payer: UHC Medicaid |
$9,771.73
|
| Rate for Payer: UHCCP Medicaid |
$9,771.73
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$12,859.19
|
|
|
Service Code
|
APR-DRG 3083
|
| Min. Negotiated Rate |
$11,626.24 |
| Max. Negotiated Rate |
$12,859.19 |
| Rate for Payer: BCBS Complete |
$12,859.19
|
| Rate for Payer: Mclaren Medicaid |
$12,246.84
|
| Rate for Payer: Meridian Medicaid |
$12,859.19
|
| Rate for Payer: PHP Medicaid |
$11,626.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,246.84
|
| Rate for Payer: UHC Medicaid |
$12,246.84
|
| Rate for Payer: UHCCP Medicaid |
$12,246.84
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$7,940.47
|
|
|
Service Code
|
APR-DRG 3081
|
| Min. Negotiated Rate |
$7,179.13 |
| Max. Negotiated Rate |
$7,940.47 |
| Rate for Payer: BCBS Complete |
$7,940.47
|
| Rate for Payer: Mclaren Medicaid |
$7,562.35
|
| Rate for Payer: Meridian Medicaid |
$7,940.47
|
| Rate for Payer: PHP Medicaid |
$7,179.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,562.35
|
| Rate for Payer: UHC Medicaid |
$7,562.35
|
| Rate for Payer: UHCCP Medicaid |
$7,562.35
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$22,472.65
|
|
|
Service Code
|
APR-DRG 3084
|
| Min. Negotiated Rate |
$20,317.96 |
| Max. Negotiated Rate |
$22,472.65 |
| Rate for Payer: BCBS Complete |
$22,472.65
|
| Rate for Payer: Mclaren Medicaid |
$21,402.52
|
| Rate for Payer: Meridian Medicaid |
$22,472.65
|
| Rate for Payer: PHP Medicaid |
$20,317.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,402.52
|
| Rate for Payer: UHC Medicaid |
$21,402.52
|
| Rate for Payer: UHCCP Medicaid |
$21,402.52
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$28,775.92
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$15,995.60 |
| Max. Negotiated Rate |
$28,775.92 |
| Rate for Payer: Aetna Medicare |
$16,837.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,046.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,046.84
|
| Rate for Payer: BCBS MAPPO |
$16,837.47
|
| Rate for Payer: BCN Medicare Advantage |
$16,837.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,837.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,837.47
|
| Rate for Payer: Mclaren Medicare |
$16,837.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,679.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,363.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,521.22
|
| Rate for Payer: PACE Medicare |
$15,995.60
|
| Rate for Payer: PACE SWMI |
$16,837.47
|
| Rate for Payer: PHP Commercial |
$18,521.22
|
| Rate for Payer: PHP Medicare Advantage |
$16,837.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$28,775.92
|
| Rate for Payer: Priority Health Medicare |
$16,837.47
|
| Rate for Payer: Priority Health Narrow Network |
$23,020.73
|
| Rate for Payer: Railroad Medicare Medicare |
$16,837.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,837.47
|
| Rate for Payer: UHC Exchange |
$26,098.08
|
| Rate for Payer: UHCCP DNSP |
$16,837.47
|
| Rate for Payer: VA VA |
$16,837.47
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
|
IP
|
$40,011.51
|
|
|
Service Code
|
MSDRG 480
|
| Min. Negotiated Rate |
$21,590.32 |
| Max. Negotiated Rate |
$40,011.51 |
| Rate for Payer: Aetna Medicare |
$22,726.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,408.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,408.31
|
| Rate for Payer: BCBS MAPPO |
$22,726.65
|
| Rate for Payer: BCN Medicare Advantage |
$22,726.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,726.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,726.65
|
| Rate for Payer: Mclaren Medicare |
$22,726.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,862.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,135.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,999.31
|
| Rate for Payer: PACE Medicare |
$21,590.32
|
| Rate for Payer: PACE SWMI |
$22,726.65
|
| Rate for Payer: PHP Commercial |
$24,999.31
|
| Rate for Payer: PHP Medicare Advantage |
$22,726.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$40,011.51
|
| Rate for Payer: Priority Health Medicare |
$22,726.65
|
| Rate for Payer: Priority Health Narrow Network |
$32,009.21
|
| Rate for Payer: Railroad Medicare Medicare |
$22,726.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,726.65
|
| Rate for Payer: UHC Exchange |
$35,226.31
|
| Rate for Payer: UHCCP DNSP |
$22,726.65
|
| Rate for Payer: VA VA |
$22,726.65
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
|
IP
|
$22,407.98
|
|
|
Service Code
|
MSDRG 482
|
| Min. Negotiated Rate |
$12,824.71 |
| Max. Negotiated Rate |
$22,407.98 |
| Rate for Payer: Aetna Medicare |
$13,499.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,874.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,874.61
|
| Rate for Payer: BCBS MAPPO |
$13,499.69
|
| Rate for Payer: BCN Medicare Advantage |
$13,499.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,499.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,499.69
|
| Rate for Payer: Mclaren Medicare |
$13,499.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,174.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,524.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,849.66
|
| Rate for Payer: PACE Medicare |
$12,824.71
|
| Rate for Payer: PACE SWMI |
$13,499.69
|
| Rate for Payer: PHP Commercial |
$14,849.66
|
| Rate for Payer: PHP Medicare Advantage |
$13,499.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22,407.98
|
| Rate for Payer: Priority Health Medicare |
$13,499.69
|
| Rate for Payer: Priority Health Narrow Network |
$17,926.39
|
| Rate for Payer: Railroad Medicare Medicare |
$13,499.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,499.69
|
| Rate for Payer: UHC Exchange |
$20,924.52
|
| Rate for Payer: UHCCP DNSP |
$13,499.69
|
| Rate for Payer: VA VA |
$13,499.69
|
|
|
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
|
IP
|
$39,433.10
|
|
|
Service Code
|
MSDRG 521
|
| Min. Negotiated Rate |
$21,302.30 |
| Max. Negotiated Rate |
$39,433.10 |
| Rate for Payer: Aetna Medicare |
$22,423.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,029.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,029.34
|
| Rate for Payer: BCBS MAPPO |
$22,423.47
|
| Rate for Payer: BCN Medicare Advantage |
$22,423.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,423.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,423.47
|
| Rate for Payer: Mclaren Medicare |
$22,423.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,544.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,786.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,665.82
|
| Rate for Payer: PACE Medicare |
$21,302.30
|
| Rate for Payer: PACE SWMI |
$22,423.47
|
| Rate for Payer: PHP Commercial |
$24,665.82
|
| Rate for Payer: PHP Medicare Advantage |
$22,423.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$39,433.10
|
| Rate for Payer: Priority Health Medicare |
$22,423.47
|
| Rate for Payer: Priority Health Narrow Network |
$31,546.48
|
| Rate for Payer: Railroad Medicare Medicare |
$22,423.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,423.47
|
| Rate for Payer: UHC Exchange |
$34,756.38
|
| Rate for Payer: UHCCP DNSP |
$22,423.47
|
| Rate for Payer: VA VA |
$22,423.47
|
|
|
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
|
IP
|
$29,094.66
|
|
|
Service Code
|
MSDRG 522
|
| Min. Negotiated Rate |
$16,154.30 |
| Max. Negotiated Rate |
$29,094.66 |
| Rate for Payer: Aetna Medicare |
$17,004.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,255.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,255.66
|
| Rate for Payer: BCBS MAPPO |
$17,004.53
|
| Rate for Payer: BCN Medicare Advantage |
$17,004.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,004.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,004.53
|
| Rate for Payer: Mclaren Medicare |
$17,004.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,854.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,555.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,704.98
|
| Rate for Payer: PACE Medicare |
$16,154.30
|
| Rate for Payer: PACE SWMI |
$17,004.53
|
| Rate for Payer: PHP Commercial |
$18,704.98
|
| Rate for Payer: PHP Medicare Advantage |
$17,004.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29,094.66
|
| Rate for Payer: Priority Health Medicare |
$17,004.53
|
| Rate for Payer: Priority Health Narrow Network |
$23,275.73
|
| Rate for Payer: Railroad Medicare Medicare |
$17,004.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,004.53
|
| Rate for Payer: UHC Exchange |
$26,357.02
|
| Rate for Payer: UHCCP DNSP |
$17,004.53
|
| Rate for Payer: VA VA |
$17,004.53
|
|
|
HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$84,099.32
|
|
|
Service Code
|
MSDRG 969
|
| Min. Negotiated Rate |
$43,543.66 |
| Max. Negotiated Rate |
$84,099.32 |
| Rate for Payer: Aetna Medicare |
$45,835.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57,294.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57,294.29
|
| Rate for Payer: BCBS MAPPO |
$45,835.43
|
| Rate for Payer: BCN Medicare Advantage |
$45,835.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45,835.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$45,835.43
|
| Rate for Payer: Mclaren Medicare |
$45,835.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48,127.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52,710.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$50,418.97
|
| Rate for Payer: PACE Medicare |
$43,543.66
|
| Rate for Payer: PACE SWMI |
$45,835.43
|
| Rate for Payer: PHP Commercial |
$50,418.97
|
| Rate for Payer: PHP Medicare Advantage |
$45,835.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$84,099.32
|
| Rate for Payer: Priority Health Medicare |
$45,835.43
|
| Rate for Payer: Priority Health Narrow Network |
$67,279.45
|
| Rate for Payer: Railroad Medicare Medicare |
$45,835.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45,835.43
|
| Rate for Payer: UHC Exchange |
$71,044.92
|
| Rate for Payer: UHCCP DNSP |
$45,835.43
|
| Rate for Payer: VA VA |
$45,835.43
|
|
|
HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$36,234.71
|
|
|
Service Code
|
MSDRG 970
|
| Min. Negotiated Rate |
$19,709.66 |
| Max. Negotiated Rate |
$36,234.71 |
| Rate for Payer: Aetna Medicare |
$20,747.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,933.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,933.76
|
| Rate for Payer: BCBS MAPPO |
$20,747.01
|
| Rate for Payer: BCN Medicare Advantage |
$20,747.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,747.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,747.01
|
| Rate for Payer: Mclaren Medicare |
$20,747.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,784.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,859.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$22,821.71
|
| Rate for Payer: PACE Medicare |
$19,709.66
|
| Rate for Payer: PACE SWMI |
$20,747.01
|
| Rate for Payer: PHP Commercial |
$22,821.71
|
| Rate for Payer: PHP Medicare Advantage |
$20,747.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36,234.71
|
| Rate for Payer: Priority Health Medicare |
$20,747.01
|
| Rate for Payer: Priority Health Narrow Network |
$28,987.77
|
| Rate for Payer: Railroad Medicare Medicare |
$20,747.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20,747.01
|
| Rate for Payer: UHC Exchange |
$32,157.87
|
| Rate for Payer: UHCCP DNSP |
$20,747.01
|
| Rate for Payer: VA VA |
$20,747.01
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION OR MULTIPLE HIV SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$4,199.93
|
|
|
Service Code
|
APR-DRG 8911
|
| Min. Negotiated Rate |
$3,797.24 |
| Max. Negotiated Rate |
$4,199.93 |
| Rate for Payer: BCBS Complete |
$4,199.93
|
| Rate for Payer: Mclaren Medicaid |
$3,999.93
|
| Rate for Payer: Meridian Medicaid |
$4,199.93
|
| Rate for Payer: PHP Medicaid |
$3,797.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,999.93
|
| Rate for Payer: UHC Medicaid |
$3,999.93
|
| Rate for Payer: UHCCP Medicaid |
$3,999.93
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION OR MULTIPLE HIV SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$5,814.07
|
|
|
Service Code
|
APR-DRG 8913
|
| Min. Negotiated Rate |
$5,256.62 |
| Max. Negotiated Rate |
$5,814.07 |
| Rate for Payer: BCBS Complete |
$5,814.07
|
| Rate for Payer: Mclaren Medicaid |
$5,537.21
|
| Rate for Payer: Meridian Medicaid |
$5,814.07
|
| Rate for Payer: PHP Medicaid |
$5,256.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,537.21
|
| Rate for Payer: UHC Medicaid |
$5,537.21
|
| Rate for Payer: UHCCP Medicaid |
$5,537.21
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION OR MULTIPLE HIV SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$4,420.63
|
|
|
Service Code
|
APR-DRG 8912
|
| Min. Negotiated Rate |
$3,996.78 |
| Max. Negotiated Rate |
$4,420.63 |
| Rate for Payer: BCBS Complete |
$4,420.63
|
| Rate for Payer: Mclaren Medicaid |
$4,210.13
|
| Rate for Payer: Meridian Medicaid |
$4,420.63
|
| Rate for Payer: PHP Medicaid |
$3,996.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,210.13
|
| Rate for Payer: UHC Medicaid |
$4,210.13
|
| Rate for Payer: UHCCP Medicaid |
$4,210.13
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION OR MULTIPLE HIV SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$9,560.06
|
|
|
Service Code
|
APR-DRG 8914
|
| Min. Negotiated Rate |
$8,643.44 |
| Max. Negotiated Rate |
$9,560.06 |
| Rate for Payer: BCBS Complete |
$9,560.06
|
| Rate for Payer: Mclaren Medicaid |
$9,104.82
|
| Rate for Payer: Meridian Medicaid |
$9,560.06
|
| Rate for Payer: PHP Medicaid |
$8,643.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,104.82
|
| Rate for Payer: UHC Medicaid |
$9,104.82
|
| Rate for Payer: UHCCP Medicaid |
$9,104.82
|
|
|
HIV WITH MAJOR RELATED CONDITION WITH CC
|
Facility
|
IP
|
$17,791.75
|
|
|
Service Code
|
MSDRG 975
|
| Min. Negotiated Rate |
$10,526.07 |
| Max. Negotiated Rate |
$17,791.75 |
| Rate for Payer: Aetna Medicare |
$11,080.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,850.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,850.09
|
| Rate for Payer: BCBS MAPPO |
$11,080.07
|
| Rate for Payer: BCN Medicare Advantage |
$11,080.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,080.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,080.07
|
| Rate for Payer: Mclaren Medicare |
$11,080.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,634.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,742.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,188.08
|
| Rate for Payer: PACE Medicare |
$10,526.07
|
| Rate for Payer: PACE SWMI |
$11,080.07
|
| Rate for Payer: PHP Commercial |
$12,188.08
|
| Rate for Payer: PHP Medicare Advantage |
$11,080.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,791.75
|
| Rate for Payer: Priority Health Medicare |
$11,080.07
|
| Rate for Payer: Priority Health Narrow Network |
$14,233.40
|
| Rate for Payer: Railroad Medicare Medicare |
$11,080.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,080.07
|
| Rate for Payer: UHC Exchange |
$17,174.11
|
| Rate for Payer: UHCCP DNSP |
$11,080.07
|
| Rate for Payer: VA VA |
$11,080.07
|
|
|
HIV WITH MAJOR RELATED CONDITION WITH MCC
|
Facility
|
IP
|
$39,650.18
|
|
|
Service Code
|
MSDRG 974
|
| Min. Negotiated Rate |
$21,410.38 |
| Max. Negotiated Rate |
$39,650.18 |
| Rate for Payer: Aetna Medicare |
$22,537.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,171.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,171.55
|
| Rate for Payer: BCBS MAPPO |
$22,537.24
|
| Rate for Payer: BCN Medicare Advantage |
$22,537.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,537.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,537.24
|
| Rate for Payer: Mclaren Medicare |
$22,537.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,664.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,917.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,790.96
|
| Rate for Payer: PACE Medicare |
$21,410.38
|
| Rate for Payer: PACE SWMI |
$22,537.24
|
| Rate for Payer: PHP Commercial |
$24,790.96
|
| Rate for Payer: PHP Medicare Advantage |
$22,537.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$39,650.18
|
| Rate for Payer: Priority Health Medicare |
$22,537.24
|
| Rate for Payer: Priority Health Narrow Network |
$31,720.14
|
| Rate for Payer: Railroad Medicare Medicare |
$22,537.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,537.24
|
| Rate for Payer: UHC Exchange |
$34,932.72
|
| Rate for Payer: UHCCP DNSP |
$22,537.24
|
| Rate for Payer: VA VA |
$22,537.24
|
|
|
HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC
|
Facility
|
IP
|
$12,795.30
|
|
|
Service Code
|
MSDRG 976
|
| Min. Negotiated Rate |
$7,842.28 |
| Max. Negotiated Rate |
$12,795.30 |
| Rate for Payer: Aetna Medicare |
$8,255.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,318.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,318.79
|
| Rate for Payer: BCBS MAPPO |
$8,255.03
|
| Rate for Payer: BCN Medicare Advantage |
$8,255.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,255.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,255.03
|
| Rate for Payer: Mclaren Medicare |
$8,255.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,667.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,493.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,080.53
|
| Rate for Payer: PACE Medicare |
$7,842.28
|
| Rate for Payer: PACE SWMI |
$8,255.03
|
| Rate for Payer: PHP Commercial |
$9,080.53
|
| Rate for Payer: PHP Medicare Advantage |
$8,255.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12,402.01
|
| Rate for Payer: Priority Health Medicare |
$8,255.03
|
| Rate for Payer: Priority Health Narrow Network |
$9,921.61
|
| Rate for Payer: Railroad Medicare Medicare |
$8,255.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,255.03
|
| Rate for Payer: UHC Exchange |
$12,795.30
|
| Rate for Payer: UHCCP DNSP |
$8,255.03
|
| Rate for Payer: VA VA |
$8,255.03
|
|
|
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
|
Facility
|
IP
|
$6,933.94
|
|
|
Service Code
|
APR-DRG 8902
|
| Min. Negotiated Rate |
$6,269.11 |
| Max. Negotiated Rate |
$6,933.94 |
| Rate for Payer: BCBS Complete |
$6,933.94
|
| Rate for Payer: Mclaren Medicaid |
$6,603.76
|
| Rate for Payer: Meridian Medicaid |
$6,933.94
|
| Rate for Payer: PHP Medicaid |
$6,269.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,603.76
|
| Rate for Payer: UHC Medicaid |
$6,603.76
|
| Rate for Payer: UHCCP Medicaid |
$6,603.76
|
|
