|
MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITH MCC
|
Facility
|
IP
|
$20,060.02
|
|
|
Service Code
|
MSDRG 725
|
| Min. Negotiated Rate |
$12,294.85 |
| Max. Negotiated Rate |
$20,060.02 |
| Rate for Payer: Aetna Medicare |
$12,941.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,177.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,177.44
|
| Rate for Payer: BCBS MAPPO |
$12,941.95
|
| Rate for Payer: BCN Medicare Advantage |
$12,941.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,941.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,941.95
|
| Rate for Payer: Mclaren Medicare |
$12,941.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,589.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,883.24
|
| Rate for Payer: PACE Medicare |
$12,294.85
|
| Rate for Payer: PACE SWMI |
$12,941.95
|
| Rate for Payer: PHP Commercial |
$14,236.15
|
| Rate for Payer: PHP Medicare Advantage |
$12,941.95
|
| Rate for Payer: Priority Health Medicare |
$12,941.95
|
| Rate for Payer: Railroad Medicare Medicare |
$12,941.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,941.95
|
| Rate for Payer: UHC Exchange |
$20,060.02
|
| Rate for Payer: UHC Medicare Advantage |
$12,941.95
|
| Rate for Payer: UHCCP DNSP |
$12,941.95
|
| Rate for Payer: VA VA |
$12,941.95
|
|
|
MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC
|
Facility
|
IP
|
$12,892.87
|
|
|
Service Code
|
MSDRG 726
|
| Min. Negotiated Rate |
$7,902.08 |
| Max. Negotiated Rate |
$12,892.87 |
| Rate for Payer: Aetna Medicare |
$8,317.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,397.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,397.48
|
| Rate for Payer: BCBS MAPPO |
$8,317.98
|
| Rate for Payer: BCN Medicare Advantage |
$8,317.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,317.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,317.98
|
| Rate for Payer: Mclaren Medicare |
$8,317.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,733.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,565.68
|
| Rate for Payer: PACE Medicare |
$7,902.08
|
| Rate for Payer: PACE SWMI |
$8,317.98
|
| Rate for Payer: PHP Commercial |
$9,149.78
|
| Rate for Payer: PHP Medicare Advantage |
$8,317.98
|
| Rate for Payer: Priority Health Medicare |
$8,317.98
|
| Rate for Payer: Railroad Medicare Medicare |
$8,317.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,317.98
|
| Rate for Payer: UHC Exchange |
$12,892.87
|
| Rate for Payer: UHC Medicare Advantage |
$8,317.98
|
| Rate for Payer: UHCCP DNSP |
$8,317.98
|
| Rate for Payer: VA VA |
$8,317.98
|
|
|
MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
|
IP
|
$87,472.92
|
|
|
Service Code
|
MSDRG 461
|
| Min. Negotiated Rate |
$53,612.43 |
| Max. Negotiated Rate |
$87,472.92 |
| Rate for Payer: Aetna Medicare |
$56,434.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70,542.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70,542.68
|
| Rate for Payer: BCBS MAPPO |
$56,434.14
|
| Rate for Payer: BCN Medicare Advantage |
$56,434.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56,434.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$56,434.14
|
| Rate for Payer: Mclaren Medicare |
$56,434.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59,255.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64,899.26
|
| Rate for Payer: PACE Medicare |
$53,612.43
|
| Rate for Payer: PACE SWMI |
$56,434.14
|
| Rate for Payer: PHP Commercial |
$62,077.55
|
| Rate for Payer: PHP Medicare Advantage |
$56,434.14
|
| Rate for Payer: Priority Health Medicare |
$56,434.14
|
| Rate for Payer: Railroad Medicare Medicare |
$56,434.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$56,434.14
|
| Rate for Payer: UHC Exchange |
$87,472.92
|
| Rate for Payer: UHC Medicare Advantage |
$56,434.14
|
| Rate for Payer: UHCCP DNSP |
$56,434.14
|
| Rate for Payer: VA VA |
$56,434.14
|
|
|
MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$42,205.96
|
|
|
Service Code
|
MSDRG 462
|
| Min. Negotiated Rate |
$25,868.17 |
| Max. Negotiated Rate |
$42,205.96 |
| Rate for Payer: Aetna Medicare |
$27,229.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,037.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,037.06
|
| Rate for Payer: BCBS MAPPO |
$27,229.65
|
| Rate for Payer: BCN Medicare Advantage |
$27,229.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,229.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$27,229.65
|
| Rate for Payer: Mclaren Medicare |
$27,229.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,591.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,314.10
|
| Rate for Payer: PACE Medicare |
$25,868.17
|
| Rate for Payer: PACE SWMI |
$27,229.65
|
| Rate for Payer: PHP Commercial |
$29,952.62
|
| Rate for Payer: PHP Medicare Advantage |
$27,229.65
|
| Rate for Payer: Priority Health Medicare |
$27,229.65
|
| Rate for Payer: Railroad Medicare Medicare |
$27,229.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,229.65
|
| Rate for Payer: UHC Exchange |
$42,205.96
|
| Rate for Payer: UHC Medicare Advantage |
$27,229.65
|
| Rate for Payer: UHCCP DNSP |
$27,229.65
|
| Rate for Payer: VA VA |
$27,229.65
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$31,593.57
|
|
|
Service Code
|
MSDRG 409
|
| Min. Negotiated Rate |
$19,363.80 |
| Max. Negotiated Rate |
$31,593.57 |
| Rate for Payer: Aetna Medicare |
$20,382.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,478.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,478.69
|
| Rate for Payer: BCBS MAPPO |
$20,382.95
|
| Rate for Payer: BCN Medicare Advantage |
$20,382.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,382.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,382.95
|
| Rate for Payer: Mclaren Medicare |
$20,382.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,402.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,440.39
|
| Rate for Payer: PACE Medicare |
$19,363.80
|
| Rate for Payer: PACE SWMI |
$20,382.95
|
| Rate for Payer: PHP Commercial |
$22,421.24
|
| Rate for Payer: PHP Medicare Advantage |
$20,382.95
|
| Rate for Payer: Priority Health Medicare |
$20,382.95
|
| Rate for Payer: Railroad Medicare Medicare |
$20,382.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,382.95
|
| Rate for Payer: UHC Exchange |
$31,593.57
|
| Rate for Payer: UHC Medicare Advantage |
$20,382.95
|
| Rate for Payer: UHCCP DNSP |
$20,382.95
|
| Rate for Payer: VA VA |
$20,382.95
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$51,023.12
|
|
|
Service Code
|
MSDRG 408
|
| Min. Negotiated Rate |
$31,272.23 |
| Max. Negotiated Rate |
$51,023.12 |
| Rate for Payer: Aetna Medicare |
$32,918.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41,147.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41,147.68
|
| Rate for Payer: BCBS MAPPO |
$32,918.14
|
| Rate for Payer: BCN Medicare Advantage |
$32,918.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,918.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$32,918.14
|
| Rate for Payer: Mclaren Medicare |
$32,918.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34,564.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,855.86
|
| Rate for Payer: PACE Medicare |
$31,272.23
|
| Rate for Payer: PACE SWMI |
$32,918.14
|
| Rate for Payer: PHP Commercial |
$36,209.95
|
| Rate for Payer: PHP Medicare Advantage |
$32,918.14
|
| Rate for Payer: Priority Health Medicare |
$32,918.14
|
| Rate for Payer: Railroad Medicare Medicare |
$32,918.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,918.14
|
| Rate for Payer: UHC Exchange |
$51,023.12
|
| Rate for Payer: UHC Medicare Advantage |
$32,918.14
|
| Rate for Payer: UHCCP DNSP |
$32,918.14
|
| Rate for Payer: VA VA |
$32,918.14
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$24,050.20
|
|
|
Service Code
|
MSDRG 410
|
| Min. Negotiated Rate |
$14,740.45 |
| Max. Negotiated Rate |
$24,050.20 |
| Rate for Payer: Aetna Medicare |
$15,516.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,395.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,395.33
|
| Rate for Payer: BCBS MAPPO |
$15,516.26
|
| Rate for Payer: BCN Medicare Advantage |
$15,516.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,516.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,516.26
|
| Rate for Payer: Mclaren Medicare |
$15,516.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,292.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,843.70
|
| Rate for Payer: PACE Medicare |
$14,740.45
|
| Rate for Payer: PACE SWMI |
$15,516.26
|
| Rate for Payer: PHP Commercial |
$17,067.89
|
| Rate for Payer: PHP Medicare Advantage |
$15,516.26
|
| Rate for Payer: Priority Health Medicare |
$15,516.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15,516.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,516.26
|
| Rate for Payer: UHC Exchange |
$24,050.20
|
| Rate for Payer: UHC Medicare Advantage |
$15,516.26
|
| Rate for Payer: UHCCP DNSP |
$15,516.26
|
| Rate for Payer: VA VA |
$15,516.26
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$34,942.01
|
|
|
Service Code
|
MSDRG 478
|
| Min. Negotiated Rate |
$21,416.07 |
| Max. Negotiated Rate |
$34,942.01 |
| Rate for Payer: Aetna Medicare |
$22,543.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,179.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,179.04
|
| Rate for Payer: BCBS MAPPO |
$22,543.23
|
| Rate for Payer: BCN Medicare Advantage |
$22,543.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,543.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,543.23
|
| Rate for Payer: Mclaren Medicare |
$22,543.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,670.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,924.71
|
| Rate for Payer: PACE Medicare |
$21,416.07
|
| Rate for Payer: PACE SWMI |
$22,543.23
|
| Rate for Payer: PHP Commercial |
$24,797.55
|
| Rate for Payer: PHP Medicare Advantage |
$22,543.23
|
| Rate for Payer: Priority Health Medicare |
$22,543.23
|
| Rate for Payer: Railroad Medicare Medicare |
$22,543.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,543.23
|
| Rate for Payer: UHC Exchange |
$34,942.01
|
| Rate for Payer: UHC Medicare Advantage |
$22,543.23
|
| Rate for Payer: UHCCP DNSP |
$22,543.23
|
| Rate for Payer: VA VA |
$22,543.23
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$50,161.47
|
|
|
Service Code
|
MSDRG 477
|
| Min. Negotiated Rate |
$30,744.13 |
| Max. Negotiated Rate |
$50,161.47 |
| Rate for Payer: Aetna Medicare |
$32,362.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,452.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,452.80
|
| Rate for Payer: BCBS MAPPO |
$32,362.24
|
| Rate for Payer: BCN Medicare Advantage |
$32,362.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,362.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$32,362.24
|
| Rate for Payer: Mclaren Medicare |
$32,362.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33,980.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,216.58
|
| Rate for Payer: PACE Medicare |
$30,744.13
|
| Rate for Payer: PACE SWMI |
$32,362.24
|
| Rate for Payer: PHP Commercial |
$35,598.46
|
| Rate for Payer: PHP Medicare Advantage |
$32,362.24
|
| Rate for Payer: Priority Health Medicare |
$32,362.24
|
| Rate for Payer: Railroad Medicare Medicare |
$32,362.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,362.24
|
| Rate for Payer: UHC Exchange |
$50,161.47
|
| Rate for Payer: UHC Medicare Advantage |
$32,362.24
|
| Rate for Payer: UHCCP DNSP |
$32,362.24
|
| Rate for Payer: VA VA |
$32,362.24
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$27,158.00
|
|
|
Service Code
|
MSDRG 479
|
| Min. Negotiated Rate |
$16,645.23 |
| Max. Negotiated Rate |
$27,158.00 |
| Rate for Payer: Aetna Medicare |
$17,521.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,901.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,901.61
|
| Rate for Payer: BCBS MAPPO |
$17,521.29
|
| Rate for Payer: BCN Medicare Advantage |
$17,521.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,521.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,521.29
|
| Rate for Payer: Mclaren Medicare |
$17,521.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,397.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,149.48
|
| Rate for Payer: PACE Medicare |
$16,645.23
|
| Rate for Payer: PACE SWMI |
$17,521.29
|
| Rate for Payer: PHP Commercial |
$19,273.42
|
| Rate for Payer: PHP Medicare Advantage |
$17,521.29
|
| Rate for Payer: Priority Health Medicare |
$17,521.29
|
| Rate for Payer: Railroad Medicare Medicare |
$17,521.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,521.29
|
| Rate for Payer: UHC Exchange |
$27,158.00
|
| Rate for Payer: UHC Medicare Advantage |
$17,521.29
|
| Rate for Payer: UHCCP DNSP |
$17,521.29
|
| Rate for Payer: VA VA |
$17,521.29
|
|
|
MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITH MCC
|
Facility
|
IP
|
$20,660.28
|
|
|
Service Code
|
MSDRG 553
|
| Min. Negotiated Rate |
$12,662.75 |
| Max. Negotiated Rate |
$20,660.28 |
| Rate for Payer: Aetna Medicare |
$13,329.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,661.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,661.51
|
| Rate for Payer: BCBS MAPPO |
$13,329.21
|
| Rate for Payer: BCN Medicare Advantage |
$13,329.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,329.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,329.21
|
| Rate for Payer: Mclaren Medicare |
$13,329.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,995.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,328.59
|
| Rate for Payer: PACE Medicare |
$12,662.75
|
| Rate for Payer: PACE SWMI |
$13,329.21
|
| Rate for Payer: PHP Commercial |
$14,662.13
|
| Rate for Payer: PHP Medicare Advantage |
$13,329.21
|
| Rate for Payer: Priority Health Medicare |
$13,329.21
|
| Rate for Payer: Railroad Medicare Medicare |
$13,329.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,329.21
|
| Rate for Payer: UHC Exchange |
$20,660.28
|
| Rate for Payer: UHC Medicare Advantage |
$13,329.21
|
| Rate for Payer: UHCCP DNSP |
$13,329.21
|
| Rate for Payer: VA VA |
$13,329.21
|
|
|
MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC
|
Facility
|
IP
|
$14,140.42
|
|
|
Service Code
|
MSDRG 554
|
| Min. Negotiated Rate |
$8,666.71 |
| Max. Negotiated Rate |
$14,140.42 |
| Rate for Payer: Aetna Medicare |
$9,122.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,403.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,403.56
|
| Rate for Payer: BCBS MAPPO |
$9,122.85
|
| Rate for Payer: BCN Medicare Advantage |
$9,122.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,122.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,122.85
|
| Rate for Payer: Mclaren Medicare |
$9,122.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,578.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,491.28
|
| Rate for Payer: PACE Medicare |
$8,666.71
|
| Rate for Payer: PACE SWMI |
$9,122.85
|
| Rate for Payer: PHP Commercial |
$10,035.14
|
| Rate for Payer: PHP Medicare Advantage |
$9,122.85
|
| Rate for Payer: Priority Health Medicare |
$9,122.85
|
| Rate for Payer: Railroad Medicare Medicare |
$9,122.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,122.85
|
| Rate for Payer: UHC Exchange |
$14,140.42
|
| Rate for Payer: UHC Medicare Advantage |
$9,122.85
|
| Rate for Payer: UHCCP DNSP |
$9,122.85
|
| Rate for Payer: VA VA |
$9,122.85
|
|
|
MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$30,914.46
|
|
|
Service Code
|
MSDRG 584
|
| Min. Negotiated Rate |
$18,947.57 |
| Max. Negotiated Rate |
$30,914.46 |
| Rate for Payer: Aetna Medicare |
$19,944.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,931.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,931.01
|
| Rate for Payer: BCBS MAPPO |
$19,944.81
|
| Rate for Payer: BCN Medicare Advantage |
$19,944.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,944.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,944.81
|
| Rate for Payer: Mclaren Medicare |
$19,944.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,942.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,936.53
|
| Rate for Payer: PACE Medicare |
$18,947.57
|
| Rate for Payer: PACE SWMI |
$19,944.81
|
| Rate for Payer: PHP Commercial |
$21,939.29
|
| Rate for Payer: PHP Medicare Advantage |
$19,944.81
|
| Rate for Payer: Priority Health Medicare |
$19,944.81
|
| Rate for Payer: Railroad Medicare Medicare |
$19,944.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,944.81
|
| Rate for Payer: UHC Exchange |
$30,914.46
|
| Rate for Payer: UHC Medicare Advantage |
$19,944.81
|
| Rate for Payer: UHCCP DNSP |
$19,944.81
|
| Rate for Payer: VA VA |
$19,944.81
|
|
|
MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$30,052.81
|
|
|
Service Code
|
MSDRG 585
|
| Min. Negotiated Rate |
$18,419.46 |
| Max. Negotiated Rate |
$30,052.81 |
| Rate for Payer: Aetna Medicare |
$19,388.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,236.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,236.14
|
| Rate for Payer: BCBS MAPPO |
$19,388.91
|
| Rate for Payer: BCN Medicare Advantage |
$19,388.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,388.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,388.91
|
| Rate for Payer: Mclaren Medicare |
$19,388.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,358.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,297.25
|
| Rate for Payer: PACE Medicare |
$18,419.46
|
| Rate for Payer: PACE SWMI |
$19,388.91
|
| Rate for Payer: PHP Commercial |
$21,327.80
|
| Rate for Payer: PHP Medicare Advantage |
$19,388.91
|
| Rate for Payer: Priority Health Medicare |
$19,388.91
|
| Rate for Payer: Railroad Medicare Medicare |
$19,388.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,388.91
|
| Rate for Payer: UHC Exchange |
$30,052.81
|
| Rate for Payer: UHC Medicare Advantage |
$19,388.91
|
| Rate for Payer: UHCCP DNSP |
$19,388.91
|
| Rate for Payer: VA VA |
$19,388.91
|
|
|
MS-DRG 42.00: BRONCHITIS AND ASTHMA WITH CC/MCC
|
Facility
|
IP
|
$15,967.48
|
|
|
Service Code
|
MSDRG 202
|
| Min. Negotiated Rate |
$9,786.52 |
| Max. Negotiated Rate |
$15,967.48 |
| Rate for Payer: Aetna Medicare |
$10,301.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,877.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,877.00
|
| Rate for Payer: BCBS MAPPO |
$10,301.60
|
| Rate for Payer: BCN Medicare Advantage |
$10,301.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,301.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,301.60
|
| Rate for Payer: Mclaren Medicare |
$10,301.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,816.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,846.84
|
| Rate for Payer: PACE Medicare |
$9,786.52
|
| Rate for Payer: PACE SWMI |
$10,301.60
|
| Rate for Payer: PHP Commercial |
$11,331.76
|
| Rate for Payer: PHP Medicare Advantage |
$10,301.60
|
| Rate for Payer: Priority Health Medicare |
$10,301.60
|
| Rate for Payer: Railroad Medicare Medicare |
$10,301.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,301.60
|
| Rate for Payer: UHC Exchange |
$15,967.48
|
| Rate for Payer: UHC Medicare Advantage |
$10,301.60
|
| Rate for Payer: UHCCP DNSP |
$10,301.60
|
| Rate for Payer: VA VA |
$10,301.60
|
|
|
MS-DRG 42.00: BRONCHITIS AND ASTHMA WITHOUT CC/MCC
|
Facility
|
IP
|
$12,231.75
|
|
|
Service Code
|
MSDRG 203
|
| Min. Negotiated Rate |
$7,496.88 |
| Max. Negotiated Rate |
$12,231.75 |
| Rate for Payer: Aetna Medicare |
$7,891.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,864.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,864.31
|
| Rate for Payer: BCBS MAPPO |
$7,891.45
|
| Rate for Payer: BCN Medicare Advantage |
$7,891.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,891.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,891.45
|
| Rate for Payer: Mclaren Medicare |
$7,891.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,286.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,075.17
|
| Rate for Payer: PACE Medicare |
$7,496.88
|
| Rate for Payer: PACE SWMI |
$7,891.45
|
| Rate for Payer: PHP Commercial |
$8,680.59
|
| Rate for Payer: PHP Medicare Advantage |
$7,891.45
|
| Rate for Payer: Priority Health Medicare |
$7,891.45
|
| Rate for Payer: Railroad Medicare Medicare |
$7,891.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,891.45
|
| Rate for Payer: UHC Exchange |
$12,231.75
|
| Rate for Payer: UHC Medicare Advantage |
$7,891.45
|
| Rate for Payer: UHCCP DNSP |
$7,891.45
|
| Rate for Payer: VA VA |
$7,891.45
|
|
|
MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH CC
|
Facility
|
IP
|
$12,339.63
|
|
|
Service Code
|
MSDRG 297
|
| Min. Negotiated Rate |
$7,563.00 |
| Max. Negotiated Rate |
$12,339.63 |
| Rate for Payer: Aetna Medicare |
$7,961.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,951.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,951.31
|
| Rate for Payer: BCBS MAPPO |
$7,961.05
|
| Rate for Payer: BCN Medicare Advantage |
$7,961.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,961.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,961.05
|
| Rate for Payer: Mclaren Medicare |
$7,961.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,359.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,155.21
|
| Rate for Payer: PACE Medicare |
$7,563.00
|
| Rate for Payer: PACE SWMI |
$7,961.05
|
| Rate for Payer: PHP Commercial |
$8,757.16
|
| Rate for Payer: PHP Medicare Advantage |
$7,961.05
|
| Rate for Payer: Priority Health Medicare |
$7,961.05
|
| Rate for Payer: Railroad Medicare Medicare |
$7,961.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,961.05
|
| Rate for Payer: UHC Exchange |
$12,339.63
|
| Rate for Payer: UHC Medicare Advantage |
$7,961.05
|
| Rate for Payer: UHCCP DNSP |
$7,961.05
|
| Rate for Payer: VA VA |
$7,961.05
|
|
|
MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH MCC
|
Facility
|
IP
|
$25,257.65
|
|
|
Service Code
|
MSDRG 296
|
| Min. Negotiated Rate |
$15,480.50 |
| Max. Negotiated Rate |
$25,257.65 |
| Rate for Payer: Aetna Medicare |
$16,295.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,369.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,369.08
|
| Rate for Payer: BCBS MAPPO |
$16,295.26
|
| Rate for Payer: BCN Medicare Advantage |
$16,295.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,295.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,295.26
|
| Rate for Payer: Mclaren Medicare |
$16,295.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,110.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,739.55
|
| Rate for Payer: PACE Medicare |
$15,480.50
|
| Rate for Payer: PACE SWMI |
$16,295.26
|
| Rate for Payer: PHP Commercial |
$17,924.79
|
| Rate for Payer: PHP Medicare Advantage |
$16,295.26
|
| Rate for Payer: Priority Health Medicare |
$16,295.26
|
| Rate for Payer: Railroad Medicare Medicare |
$16,295.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,295.26
|
| Rate for Payer: UHC Exchange |
$25,257.65
|
| Rate for Payer: UHC Medicare Advantage |
$16,295.26
|
| Rate for Payer: UHCCP DNSP |
$16,295.26
|
| Rate for Payer: VA VA |
$16,295.26
|
|
|
MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC
|
Facility
|
IP
|
$8,706.27
|
|
|
Service Code
|
MSDRG 298
|
| Min. Negotiated Rate |
$5,336.10 |
| Max. Negotiated Rate |
$8,706.27 |
| Rate for Payer: Aetna Medicare |
$5,616.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,021.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,021.19
|
| Rate for Payer: BCBS MAPPO |
$5,616.95
|
| Rate for Payer: BCN Medicare Advantage |
$5,616.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,616.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,616.95
|
| Rate for Payer: Mclaren Medicare |
$5,616.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,897.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,459.49
|
| Rate for Payer: PACE Medicare |
$5,336.10
|
| Rate for Payer: PACE SWMI |
$5,616.95
|
| Rate for Payer: PHP Commercial |
$6,178.65
|
| Rate for Payer: PHP Medicare Advantage |
$5,616.95
|
| Rate for Payer: Priority Health Medicare |
$5,616.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5,616.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,616.95
|
| Rate for Payer: UHC Exchange |
$8,706.27
|
| Rate for Payer: UHC Medicare Advantage |
$5,616.95
|
| Rate for Payer: UHCCP DNSP |
$5,616.95
|
| Rate for Payer: VA VA |
$5,616.95
|
|
|
MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC
|
Facility
|
IP
|
$12,822.34
|
|
|
Service Code
|
MSDRG 309
|
| Min. Negotiated Rate |
$7,858.86 |
| Max. Negotiated Rate |
$12,822.34 |
| Rate for Payer: Aetna Medicare |
$8,272.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,340.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,340.60
|
| Rate for Payer: BCBS MAPPO |
$8,272.48
|
| Rate for Payer: BCN Medicare Advantage |
$8,272.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,272.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,272.48
|
| Rate for Payer: Mclaren Medicare |
$8,272.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,686.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,513.35
|
| Rate for Payer: PACE Medicare |
$7,858.86
|
| Rate for Payer: PACE SWMI |
$8,272.48
|
| Rate for Payer: PHP Commercial |
$9,099.73
|
| Rate for Payer: PHP Medicare Advantage |
$8,272.48
|
| Rate for Payer: Priority Health Medicare |
$8,272.48
|
| Rate for Payer: Railroad Medicare Medicare |
$8,272.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,272.48
|
| Rate for Payer: UHC Exchange |
$12,822.34
|
| Rate for Payer: UHC Medicare Advantage |
$8,272.48
|
| Rate for Payer: UHCCP DNSP |
$8,272.48
|
| Rate for Payer: VA VA |
$8,272.48
|
|
|
MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC
|
Facility
|
IP
|
$19,275.80
|
|
|
Service Code
|
MSDRG 308
|
| Min. Negotiated Rate |
$11,814.20 |
| Max. Negotiated Rate |
$19,275.80 |
| Rate for Payer: Aetna Medicare |
$12,436.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,545.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,545.00
|
| Rate for Payer: BCBS MAPPO |
$12,436.00
|
| Rate for Payer: BCN Medicare Advantage |
$12,436.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,436.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,436.00
|
| Rate for Payer: Mclaren Medicare |
$12,436.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,057.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,301.40
|
| Rate for Payer: PACE Medicare |
$11,814.20
|
| Rate for Payer: PACE SWMI |
$12,436.00
|
| Rate for Payer: PHP Commercial |
$13,679.60
|
| Rate for Payer: PHP Medicare Advantage |
$12,436.00
|
| Rate for Payer: Priority Health Medicare |
$12,436.00
|
| Rate for Payer: Railroad Medicare Medicare |
$12,436.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,436.00
|
| Rate for Payer: UHC Exchange |
$19,275.80
|
| Rate for Payer: UHC Medicare Advantage |
$12,436.00
|
| Rate for Payer: UHCCP DNSP |
$12,436.00
|
| Rate for Payer: VA VA |
$12,436.00
|
|
|
MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$10,335.57
|
|
|
Service Code
|
MSDRG 310
|
| Min. Negotiated Rate |
$6,334.70 |
| Max. Negotiated Rate |
$10,335.57 |
| Rate for Payer: Aetna Medicare |
$6,668.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,335.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,335.14
|
| Rate for Payer: BCBS MAPPO |
$6,668.11
|
| Rate for Payer: BCN Medicare Advantage |
$6,668.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,668.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,668.11
|
| Rate for Payer: Mclaren Medicare |
$6,668.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,001.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,668.33
|
| Rate for Payer: PACE Medicare |
$6,334.70
|
| Rate for Payer: PACE SWMI |
$6,668.11
|
| Rate for Payer: PHP Commercial |
$7,334.92
|
| Rate for Payer: PHP Medicare Advantage |
$6,668.11
|
| Rate for Payer: Priority Health Medicare |
$6,668.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6,668.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,668.11
|
| Rate for Payer: UHC Exchange |
$10,335.57
|
| Rate for Payer: UHC Medicare Advantage |
$6,668.11
|
| Rate for Payer: UHCCP DNSP |
$6,668.11
|
| Rate for Payer: VA VA |
$6,668.11
|
|
|
MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$23,307.51
|
|
|
Service Code
|
MSDRG 306
|
| Min. Negotiated Rate |
$14,285.25 |
| Max. Negotiated Rate |
$23,307.51 |
| Rate for Payer: Aetna Medicare |
$15,037.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,796.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,796.38
|
| Rate for Payer: BCBS MAPPO |
$15,037.10
|
| Rate for Payer: BCN Medicare Advantage |
$15,037.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,037.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,037.10
|
| Rate for Payer: Mclaren Medicare |
$15,037.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,788.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,292.67
|
| Rate for Payer: PACE Medicare |
$14,285.25
|
| Rate for Payer: PACE SWMI |
$15,037.10
|
| Rate for Payer: PHP Commercial |
$16,540.81
|
| Rate for Payer: PHP Medicare Advantage |
$15,037.10
|
| Rate for Payer: Priority Health Medicare |
$15,037.10
|
| Rate for Payer: Railroad Medicare Medicare |
$15,037.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,037.10
|
| Rate for Payer: UHC Exchange |
$23,307.51
|
| Rate for Payer: UHC Medicare Advantage |
$15,037.10
|
| Rate for Payer: UHCCP DNSP |
$15,037.10
|
| Rate for Payer: VA VA |
$15,037.10
|
|
|
MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$15,410.08
|
|
|
Service Code
|
MSDRG 307
|
| Min. Negotiated Rate |
$9,444.89 |
| Max. Negotiated Rate |
$15,410.08 |
| Rate for Payer: Aetna Medicare |
$9,941.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,427.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,427.49
|
| Rate for Payer: BCBS MAPPO |
$9,941.99
|
| Rate for Payer: BCN Medicare Advantage |
$9,941.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,941.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,941.99
|
| Rate for Payer: Mclaren Medicare |
$9,941.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,439.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,433.29
|
| Rate for Payer: PACE Medicare |
$9,444.89
|
| Rate for Payer: PACE SWMI |
$9,941.99
|
| Rate for Payer: PHP Commercial |
$10,936.19
|
| Rate for Payer: PHP Medicare Advantage |
$9,941.99
|
| Rate for Payer: Priority Health Medicare |
$9,941.99
|
| Rate for Payer: Railroad Medicare Medicare |
$9,941.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,941.99
|
| Rate for Payer: UHC Exchange |
$15,410.08
|
| Rate for Payer: UHC Medicare Advantage |
$9,941.99
|
| Rate for Payer: UHCCP DNSP |
$9,941.99
|
| Rate for Payer: VA VA |
$9,941.99
|
|
|
MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
|
IP
|
$100,339.76
|
|
|
Service Code
|
MSDRG 275
|
| Min. Negotiated Rate |
$61,498.56 |
| Max. Negotiated Rate |
$100,339.76 |
| Rate for Payer: Aetna Medicare |
$64,735.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80,919.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80,919.16
|
| Rate for Payer: BCBS MAPPO |
$64,735.33
|
| Rate for Payer: BCN Medicare Advantage |
$64,735.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64,735.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$64,735.33
|
| Rate for Payer: Mclaren Medicare |
$64,735.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67,972.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74,445.63
|
| Rate for Payer: PACE Medicare |
$61,498.56
|
| Rate for Payer: PACE SWMI |
$64,735.33
|
| Rate for Payer: PHP Commercial |
$71,208.86
|
| Rate for Payer: PHP Medicare Advantage |
$64,735.33
|
| Rate for Payer: Priority Health Medicare |
$64,735.33
|
| Rate for Payer: Railroad Medicare Medicare |
$64,735.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$64,735.33
|
| Rate for Payer: UHC Exchange |
$100,339.76
|
| Rate for Payer: UHC Medicare Advantage |
$64,735.33
|
| Rate for Payer: UHCCP DNSP |
$64,735.33
|
| Rate for Payer: VA VA |
$64,735.33
|
|
