|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$29,955.98
|
|
|
Service Code
|
MSDRG 415
|
| Min. Negotiated Rate |
$18,360.12 |
| Max. Negotiated Rate |
$29,955.98 |
| Rate for Payer: Aetna Medicare |
$19,326.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,158.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,158.05
|
| Rate for Payer: BCBS MAPPO |
$19,326.44
|
| Rate for Payer: BCN Medicare Advantage |
$19,326.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,326.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,326.44
|
| Rate for Payer: Mclaren Medicare |
$19,326.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,292.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,225.41
|
| Rate for Payer: PACE Medicare |
$18,360.12
|
| Rate for Payer: PACE SWMI |
$19,326.44
|
| Rate for Payer: PHP Commercial |
$21,259.08
|
| Rate for Payer: PHP Medicare Advantage |
$19,326.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27,175.35
|
| Rate for Payer: Priority Health Medicare |
$19,326.44
|
| Rate for Payer: Priority Health Narrow Network |
$21,740.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19,326.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,326.44
|
| Rate for Payer: UHC Exchange |
$29,955.98
|
| Rate for Payer: UHC Medicare Advantage |
$19,326.44
|
| Rate for Payer: UHCCP DNSP |
$19,326.44
|
| Rate for Payer: VA VA |
$19,326.44
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$51,057.70
|
|
|
Service Code
|
MSDRG 414
|
| Min. Negotiated Rate |
$31,293.43 |
| Max. Negotiated Rate |
$51,057.70 |
| Rate for Payer: Aetna Medicare |
$32,940.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41,175.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41,175.56
|
| Rate for Payer: BCBS MAPPO |
$32,940.45
|
| Rate for Payer: BCN Medicare Advantage |
$32,940.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,940.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$32,940.45
|
| Rate for Payer: Mclaren Medicare |
$32,940.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34,587.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,881.52
|
| Rate for Payer: PACE Medicare |
$31,293.43
|
| Rate for Payer: PACE SWMI |
$32,940.45
|
| Rate for Payer: PHP Commercial |
$36,234.50
|
| Rate for Payer: PHP Medicare Advantage |
$32,940.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48,135.26
|
| Rate for Payer: Priority Health Medicare |
$32,940.45
|
| Rate for Payer: Priority Health Narrow Network |
$38,508.21
|
| Rate for Payer: Railroad Medicare Medicare |
$32,940.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,940.45
|
| Rate for Payer: UHC Exchange |
$51,057.70
|
| Rate for Payer: UHC Medicare Advantage |
$32,940.45
|
| Rate for Payer: UHCCP DNSP |
$32,940.45
|
| Rate for Payer: VA VA |
$32,940.45
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$21,548.22
|
|
|
Service Code
|
MSDRG 416
|
| Min. Negotiated Rate |
$13,206.98 |
| Max. Negotiated Rate |
$21,548.22 |
| Rate for Payer: Aetna Medicare |
$13,902.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,377.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,377.60
|
| Rate for Payer: BCBS MAPPO |
$13,902.08
|
| Rate for Payer: BCN Medicare Advantage |
$13,902.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,902.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,902.08
|
| Rate for Payer: Mclaren Medicare |
$13,902.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,597.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,987.39
|
| Rate for Payer: PACE Medicare |
$13,206.98
|
| Rate for Payer: PACE SWMI |
$13,902.08
|
| Rate for Payer: PHP Commercial |
$15,292.29
|
| Rate for Payer: PHP Medicare Advantage |
$13,902.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,824.90
|
| Rate for Payer: Priority Health Medicare |
$13,902.08
|
| Rate for Payer: Priority Health Narrow Network |
$15,059.92
|
| Rate for Payer: Railroad Medicare Medicare |
$13,902.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,902.08
|
| Rate for Payer: UHC Exchange |
$21,548.22
|
| Rate for Payer: UHC Medicare Advantage |
$13,902.08
|
| Rate for Payer: UHCCP DNSP |
$13,902.08
|
| Rate for Payer: VA VA |
$13,902.08
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH CC
|
Facility
|
IP
|
$32,079.02
|
|
|
Service Code
|
MSDRG 412
|
| Min. Negotiated Rate |
$19,661.33 |
| Max. Negotiated Rate |
$32,079.02 |
| Rate for Payer: Aetna Medicare |
$20,696.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,870.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,870.18
|
| Rate for Payer: BCBS MAPPO |
$20,696.14
|
| Rate for Payer: BCN Medicare Advantage |
$20,696.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,696.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,696.14
|
| Rate for Payer: Mclaren Medicare |
$20,696.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,730.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,800.56
|
| Rate for Payer: PACE Medicare |
$19,661.33
|
| Rate for Payer: PACE SWMI |
$20,696.14
|
| Rate for Payer: PHP Commercial |
$22,765.75
|
| Rate for Payer: PHP Medicare Advantage |
$20,696.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29,284.25
|
| Rate for Payer: Priority Health Medicare |
$20,696.14
|
| Rate for Payer: Priority Health Narrow Network |
$23,427.40
|
| Rate for Payer: Railroad Medicare Medicare |
$20,696.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,696.14
|
| Rate for Payer: UHC Exchange |
$32,079.02
|
| Rate for Payer: UHC Medicare Advantage |
$20,696.14
|
| Rate for Payer: UHCCP DNSP |
$20,696.14
|
| Rate for Payer: VA VA |
$20,696.14
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH MCC
|
Facility
|
IP
|
$40,443.92
|
|
|
Service Code
|
MSDRG 411
|
| Min. Negotiated Rate |
$24,788.21 |
| Max. Negotiated Rate |
$40,443.92 |
| Rate for Payer: Aetna Medicare |
$26,092.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,616.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,616.06
|
| Rate for Payer: BCBS MAPPO |
$26,092.85
|
| Rate for Payer: BCN Medicare Advantage |
$26,092.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,092.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$26,092.85
|
| Rate for Payer: Mclaren Medicare |
$26,092.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,397.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,006.78
|
| Rate for Payer: PACE Medicare |
$24,788.21
|
| Rate for Payer: PACE SWMI |
$26,092.85
|
| Rate for Payer: PHP Commercial |
$28,702.14
|
| Rate for Payer: PHP Medicare Advantage |
$26,092.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37,594.85
|
| Rate for Payer: Priority Health Medicare |
$26,092.85
|
| Rate for Payer: Priority Health Narrow Network |
$30,075.88
|
| Rate for Payer: Railroad Medicare Medicare |
$26,092.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,092.85
|
| Rate for Payer: UHC Exchange |
$40,443.92
|
| Rate for Payer: UHC Medicare Advantage |
$26,092.85
|
| Rate for Payer: UHCCP DNSP |
$26,092.85
|
| Rate for Payer: VA VA |
$26,092.85
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$25,590.96
|
|
|
Service Code
|
MSDRG 413
|
| Min. Negotiated Rate |
$15,684.78 |
| Max. Negotiated Rate |
$25,590.96 |
| Rate for Payer: Aetna Medicare |
$16,510.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,637.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,637.88
|
| Rate for Payer: BCBS MAPPO |
$16,510.30
|
| Rate for Payer: BCN Medicare Advantage |
$16,510.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,510.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,510.30
|
| Rate for Payer: Mclaren Medicare |
$16,510.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,335.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,986.84
|
| Rate for Payer: PACE Medicare |
$15,684.78
|
| Rate for Payer: PACE SWMI |
$16,510.30
|
| Rate for Payer: PHP Commercial |
$18,161.33
|
| Rate for Payer: PHP Medicare Advantage |
$16,510.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,839.38
|
| Rate for Payer: Priority Health Medicare |
$16,510.30
|
| Rate for Payer: Priority Health Narrow Network |
$18,271.50
|
| Rate for Payer: Railroad Medicare Medicare |
$16,510.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,510.30
|
| Rate for Payer: UHC Exchange |
$25,590.96
|
| Rate for Payer: UHC Medicare Advantage |
$16,510.30
|
| Rate for Payer: UHCCP DNSP |
$16,510.30
|
| Rate for Payer: VA VA |
$16,510.30
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC
|
Facility
|
IP
|
$14,479.29
|
|
|
Service Code
|
MSDRG 191
|
| Min. Negotiated Rate |
$8,874.41 |
| Max. Negotiated Rate |
$14,479.29 |
| Rate for Payer: Aetna Medicare |
$9,341.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,676.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,676.85
|
| Rate for Payer: BCBS MAPPO |
$9,341.48
|
| Rate for Payer: BCN Medicare Advantage |
$9,341.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,341.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,341.48
|
| Rate for Payer: Mclaren Medicare |
$9,341.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,808.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,742.70
|
| Rate for Payer: PACE Medicare |
$8,874.41
|
| Rate for Payer: PACE SWMI |
$9,341.48
|
| Rate for Payer: PHP Commercial |
$10,275.63
|
| Rate for Payer: PHP Medicare Advantage |
$9,341.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,803.00
|
| Rate for Payer: Priority Health Medicare |
$9,341.48
|
| Rate for Payer: Priority Health Narrow Network |
$9,442.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9,341.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,341.48
|
| Rate for Payer: UHC Exchange |
$14,479.29
|
| Rate for Payer: UHC Medicare Advantage |
$9,341.48
|
| Rate for Payer: UHCCP DNSP |
$9,341.48
|
| Rate for Payer: VA VA |
$9,341.48
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC
|
Facility
|
IP
|
$18,129.25
|
|
|
Service Code
|
MSDRG 190
|
| Min. Negotiated Rate |
$11,111.48 |
| Max. Negotiated Rate |
$18,129.25 |
| Rate for Payer: Aetna Medicare |
$11,696.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,620.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,620.36
|
| Rate for Payer: BCBS MAPPO |
$11,696.29
|
| Rate for Payer: BCN Medicare Advantage |
$11,696.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,696.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,696.29
|
| Rate for Payer: Mclaren Medicare |
$11,696.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,281.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,450.73
|
| Rate for Payer: PACE Medicare |
$11,111.48
|
| Rate for Payer: PACE SWMI |
$11,696.29
|
| Rate for Payer: PHP Commercial |
$12,865.92
|
| Rate for Payer: PHP Medicare Advantage |
$11,696.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,432.79
|
| Rate for Payer: Priority Health Medicare |
$11,696.29
|
| Rate for Payer: Priority Health Narrow Network |
$12,346.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11,696.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,696.29
|
| Rate for Payer: UHC Exchange |
$18,129.25
|
| Rate for Payer: UHC Medicare Advantage |
$11,696.29
|
| Rate for Payer: UHCCP DNSP |
$11,696.29
|
| Rate for Payer: VA VA |
$11,696.29
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$11,548.52
|
|
|
Service Code
|
MSDRG 192
|
| Min. Negotiated Rate |
$7,078.13 |
| Max. Negotiated Rate |
$11,548.52 |
| Rate for Payer: Aetna Medicare |
$7,450.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,313.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,313.32
|
| Rate for Payer: BCBS MAPPO |
$7,450.66
|
| Rate for Payer: BCN Medicare Advantage |
$7,450.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,450.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,450.66
|
| Rate for Payer: Mclaren Medicare |
$7,450.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,823.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,568.26
|
| Rate for Payer: PACE Medicare |
$7,078.13
|
| Rate for Payer: PACE SWMI |
$7,450.66
|
| Rate for Payer: PHP Commercial |
$8,195.73
|
| Rate for Payer: PHP Medicare Advantage |
$7,450.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,891.75
|
| Rate for Payer: Priority Health Medicare |
$7,450.66
|
| Rate for Payer: Priority Health Narrow Network |
$7,113.40
|
| Rate for Payer: Railroad Medicare Medicare |
$7,450.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,450.66
|
| Rate for Payer: UHC Exchange |
$11,548.52
|
| Rate for Payer: UHC Medicare Advantage |
$7,450.66
|
| Rate for Payer: UHCCP DNSP |
$7,450.66
|
| Rate for Payer: VA VA |
$7,450.66
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$33,209.00
|
|
|
Service Code
|
MSDRG 286
|
| Min. Negotiated Rate |
$20,353.90 |
| Max. Negotiated Rate |
$33,209.00 |
| Rate for Payer: Aetna Medicare |
$21,425.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,781.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,781.45
|
| Rate for Payer: BCBS MAPPO |
$21,425.16
|
| Rate for Payer: BCN Medicare Advantage |
$21,425.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,425.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,425.16
|
| Rate for Payer: Mclaren Medicare |
$21,425.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,496.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,638.93
|
| Rate for Payer: PACE Medicare |
$20,353.90
|
| Rate for Payer: PACE SWMI |
$21,425.16
|
| Rate for Payer: PHP Commercial |
$23,567.68
|
| Rate for Payer: PHP Medicare Advantage |
$21,425.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,408.09
|
| Rate for Payer: Priority Health Medicare |
$21,425.16
|
| Rate for Payer: Priority Health Narrow Network |
$24,326.47
|
| Rate for Payer: Railroad Medicare Medicare |
$21,425.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,425.16
|
| Rate for Payer: UHC Exchange |
$33,209.00
|
| Rate for Payer: UHC Medicare Advantage |
$21,425.16
|
| Rate for Payer: UHCCP DNSP |
$21,425.16
|
| Rate for Payer: VA VA |
$21,425.16
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$17,668.67
|
|
|
Service Code
|
MSDRG 287
|
| Min. Negotiated Rate |
$10,829.18 |
| Max. Negotiated Rate |
$17,668.67 |
| Rate for Payer: Aetna Medicare |
$11,399.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,248.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,248.92
|
| Rate for Payer: BCBS MAPPO |
$11,399.14
|
| Rate for Payer: BCN Medicare Advantage |
$11,399.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,399.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,399.14
|
| Rate for Payer: Mclaren Medicare |
$11,399.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,969.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,109.01
|
| Rate for Payer: PACE Medicare |
$10,829.18
|
| Rate for Payer: PACE SWMI |
$11,399.14
|
| Rate for Payer: PHP Commercial |
$12,539.05
|
| Rate for Payer: PHP Medicare Advantage |
$11,399.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,969.80
|
| Rate for Payer: Priority Health Medicare |
$11,399.14
|
| Rate for Payer: Priority Health Narrow Network |
$11,975.84
|
| Rate for Payer: Railroad Medicare Medicare |
$11,399.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,399.14
|
| Rate for Payer: UHC Exchange |
$17,668.67
|
| Rate for Payer: UHC Medicare Advantage |
$11,399.14
|
| Rate for Payer: UHCCP DNSP |
$11,399.14
|
| Rate for Payer: VA VA |
$11,399.14
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$17,393.45
|
|
|
Service Code
|
MSDRG 433
|
| Min. Negotiated Rate |
$10,660.50 |
| Max. Negotiated Rate |
$17,393.45 |
| Rate for Payer: Aetna Medicare |
$11,221.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,026.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,026.98
|
| Rate for Payer: BCBS MAPPO |
$11,221.58
|
| Rate for Payer: BCN Medicare Advantage |
$11,221.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,221.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,221.58
|
| Rate for Payer: Mclaren Medicare |
$11,221.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,782.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,904.82
|
| Rate for Payer: PACE Medicare |
$10,660.50
|
| Rate for Payer: PACE SWMI |
$11,221.58
|
| Rate for Payer: PHP Commercial |
$12,343.74
|
| Rate for Payer: PHP Medicare Advantage |
$11,221.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,696.39
|
| Rate for Payer: Priority Health Medicare |
$11,221.58
|
| Rate for Payer: Priority Health Narrow Network |
$11,757.12
|
| Rate for Payer: Railroad Medicare Medicare |
$11,221.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,221.58
|
| Rate for Payer: UHC Exchange |
$17,393.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,221.58
|
| Rate for Payer: UHCCP DNSP |
$11,221.58
|
| Rate for Payer: VA VA |
$11,221.58
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$29,693.20
|
|
|
Service Code
|
MSDRG 432
|
| Min. Negotiated Rate |
$18,199.06 |
| Max. Negotiated Rate |
$29,693.20 |
| Rate for Payer: Aetna Medicare |
$19,156.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,946.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,946.12
|
| Rate for Payer: BCBS MAPPO |
$19,156.90
|
| Rate for Payer: BCN Medicare Advantage |
$19,156.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,156.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,156.90
|
| Rate for Payer: Mclaren Medicare |
$19,156.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,114.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,030.44
|
| Rate for Payer: PACE Medicare |
$18,199.06
|
| Rate for Payer: PACE SWMI |
$19,156.90
|
| Rate for Payer: PHP Commercial |
$21,072.59
|
| Rate for Payer: PHP Medicare Advantage |
$19,156.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,915.68
|
| Rate for Payer: Priority Health Medicare |
$19,156.90
|
| Rate for Payer: Priority Health Narrow Network |
$21,532.55
|
| Rate for Payer: Railroad Medicare Medicare |
$19,156.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,156.90
|
| Rate for Payer: UHC Exchange |
$29,693.20
|
| Rate for Payer: UHC Medicare Advantage |
$19,156.90
|
| Rate for Payer: UHCCP DNSP |
$19,156.90
|
| Rate for Payer: VA VA |
$19,156.90
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,230.40
|
|
|
Service Code
|
MSDRG 434
|
| Min. Negotiated Rate |
$7,496.05 |
| Max. Negotiated Rate |
$12,230.40 |
| Rate for Payer: Aetna Medicare |
$7,890.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,863.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,863.22
|
| Rate for Payer: BCBS MAPPO |
$7,890.58
|
| Rate for Payer: BCN Medicare Advantage |
$7,890.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,890.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,890.58
|
| Rate for Payer: Mclaren Medicare |
$7,890.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,285.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,074.17
|
| Rate for Payer: PACE Medicare |
$7,496.05
|
| Rate for Payer: PACE SWMI |
$7,890.58
|
| Rate for Payer: PHP Commercial |
$8,679.64
|
| Rate for Payer: PHP Medicare Advantage |
$7,890.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,567.70
|
| Rate for Payer: Priority Health Medicare |
$7,890.58
|
| Rate for Payer: Priority Health Narrow Network |
$7,654.16
|
| Rate for Payer: Railroad Medicare Medicare |
$7,890.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,890.58
|
| Rate for Payer: UHC Exchange |
$12,230.40
|
| Rate for Payer: UHC Medicare Advantage |
$7,890.58
|
| Rate for Payer: UHCCP DNSP |
$7,890.58
|
| Rate for Payer: VA VA |
$7,890.58
|
|
|
MS-DRG 42.00: COAGULATION DISORDERS
|
Facility
|
IP
|
$24,007.35
|
|
|
Service Code
|
MSDRG 813
|
| Min. Negotiated Rate |
$14,714.18 |
| Max. Negotiated Rate |
$24,007.35 |
| Rate for Payer: Aetna Medicare |
$15,488.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,360.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,360.76
|
| Rate for Payer: BCBS MAPPO |
$15,488.61
|
| Rate for Payer: BCN Medicare Advantage |
$15,488.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,488.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,488.61
|
| Rate for Payer: Mclaren Medicare |
$15,488.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,263.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,811.90
|
| Rate for Payer: PACE Medicare |
$14,714.18
|
| Rate for Payer: PACE SWMI |
$15,488.61
|
| Rate for Payer: PHP Commercial |
$17,037.47
|
| Rate for Payer: PHP Medicare Advantage |
$15,488.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,266.29
|
| Rate for Payer: Priority Health Medicare |
$15,488.61
|
| Rate for Payer: Priority Health Narrow Network |
$17,013.03
|
| Rate for Payer: Railroad Medicare Medicare |
$15,488.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,488.61
|
| Rate for Payer: UHC Exchange |
$24,007.35
|
| Rate for Payer: UHC Medicare Advantage |
$15,488.61
|
| Rate for Payer: UHCCP DNSP |
$15,488.61
|
| Rate for Payer: VA VA |
$15,488.61
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$114,581.59
|
|
|
Service Code
|
MSDRG 429
|
| Min. Negotiated Rate |
$91,665.27 |
| Max. Negotiated Rate |
$114,581.59 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114,581.59
|
| Rate for Payer: Priority Health Narrow Network |
$91,665.27
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC
|
Facility
|
IP
|
$75,152.61
|
|
|
Service Code
|
MSDRG 430
|
| Min. Negotiated Rate |
$60,122.09 |
| Max. Negotiated Rate |
$75,152.61 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75,152.61
|
| Rate for Payer: Priority Health Narrow Network |
$60,122.09
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC
|
Facility
|
IP
|
$17,660.36
|
|
|
Service Code
|
MSDRG 381
|
| Min. Negotiated Rate |
$10,824.09 |
| Max. Negotiated Rate |
$17,660.36 |
| Rate for Payer: Aetna Medicare |
$11,393.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,242.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,242.22
|
| Rate for Payer: BCBS MAPPO |
$11,393.78
|
| Rate for Payer: BCN Medicare Advantage |
$11,393.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,393.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,393.78
|
| Rate for Payer: Mclaren Medicare |
$11,393.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,963.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,102.85
|
| Rate for Payer: PACE Medicare |
$10,824.09
|
| Rate for Payer: PACE SWMI |
$11,393.78
|
| Rate for Payer: PHP Commercial |
$12,533.16
|
| Rate for Payer: PHP Medicare Advantage |
$11,393.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,962.93
|
| Rate for Payer: Priority Health Medicare |
$11,393.78
|
| Rate for Payer: Priority Health Narrow Network |
$11,970.34
|
| Rate for Payer: Railroad Medicare Medicare |
$11,393.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,393.78
|
| Rate for Payer: UHC Exchange |
$17,660.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,393.78
|
| Rate for Payer: UHCCP DNSP |
$11,393.78
|
| Rate for Payer: VA VA |
$11,393.78
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$29,211.89
|
|
|
Service Code
|
MSDRG 380
|
| Min. Negotiated Rate |
$17,904.06 |
| Max. Negotiated Rate |
$29,211.89 |
| Rate for Payer: Aetna Medicare |
$18,846.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,557.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,557.98
|
| Rate for Payer: BCBS MAPPO |
$18,846.38
|
| Rate for Payer: BCN Medicare Advantage |
$18,846.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,846.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,846.38
|
| Rate for Payer: Mclaren Medicare |
$18,846.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,788.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,673.34
|
| Rate for Payer: PACE Medicare |
$17,904.06
|
| Rate for Payer: PACE SWMI |
$18,846.38
|
| Rate for Payer: PHP Commercial |
$20,731.02
|
| Rate for Payer: PHP Medicare Advantage |
$18,846.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,437.57
|
| Rate for Payer: Priority Health Medicare |
$18,846.38
|
| Rate for Payer: Priority Health Narrow Network |
$21,150.06
|
| Rate for Payer: Railroad Medicare Medicare |
$18,846.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,846.38
|
| Rate for Payer: UHC Exchange |
$29,211.89
|
| Rate for Payer: UHC Medicare Advantage |
$18,846.38
|
| Rate for Payer: UHCCP DNSP |
$18,846.38
|
| Rate for Payer: VA VA |
$18,846.38
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC
|
Facility
|
IP
|
$12,960.64
|
|
|
Service Code
|
MSDRG 382
|
| Min. Negotiated Rate |
$7,943.62 |
| Max. Negotiated Rate |
$12,960.64 |
| Rate for Payer: Aetna Medicare |
$8,361.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,452.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,452.12
|
| Rate for Payer: BCBS MAPPO |
$8,361.70
|
| Rate for Payer: BCN Medicare Advantage |
$8,361.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,361.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,361.70
|
| Rate for Payer: Mclaren Medicare |
$8,361.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,779.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,615.96
|
| Rate for Payer: PACE Medicare |
$7,943.62
|
| Rate for Payer: PACE SWMI |
$8,361.70
|
| Rate for Payer: PHP Commercial |
$9,197.87
|
| Rate for Payer: PHP Medicare Advantage |
$8,361.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,294.48
|
| Rate for Payer: Priority Health Medicare |
$8,361.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,235.59
|
| Rate for Payer: Railroad Medicare Medicare |
$8,361.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,361.70
|
| Rate for Payer: UHC Exchange |
$12,960.64
|
| Rate for Payer: UHC Medicare Advantage |
$8,361.70
|
| Rate for Payer: UHCCP DNSP |
$8,361.70
|
| Rate for Payer: VA VA |
$8,361.70
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC
|
Facility
|
IP
|
$16,647.95
|
|
|
Service Code
|
MSDRG 920
|
| Min. Negotiated Rate |
$10,203.58 |
| Max. Negotiated Rate |
$16,647.95 |
| Rate for Payer: Aetna Medicare |
$10,740.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,425.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,425.76
|
| Rate for Payer: BCBS MAPPO |
$10,740.61
|
| Rate for Payer: BCN Medicare Advantage |
$10,740.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,740.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,740.61
|
| Rate for Payer: Mclaren Medicare |
$10,740.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,277.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,351.70
|
| Rate for Payer: PACE Medicare |
$10,203.58
|
| Rate for Payer: PACE SWMI |
$10,740.61
|
| Rate for Payer: PHP Commercial |
$11,814.67
|
| Rate for Payer: PHP Medicare Advantage |
$10,740.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,955.87
|
| Rate for Payer: Priority Health Medicare |
$10,740.61
|
| Rate for Payer: Priority Health Narrow Network |
$11,164.70
|
| Rate for Payer: Railroad Medicare Medicare |
$10,740.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,740.61
|
| Rate for Payer: UHC Exchange |
$16,647.95
|
| Rate for Payer: UHC Medicare Advantage |
$10,740.61
|
| Rate for Payer: UHCCP DNSP |
$10,740.61
|
| Rate for Payer: VA VA |
$10,740.61
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC
|
Facility
|
IP
|
$27,819.11
|
|
|
Service Code
|
MSDRG 919
|
| Min. Negotiated Rate |
$17,050.42 |
| Max. Negotiated Rate |
$27,819.11 |
| Rate for Payer: Aetna Medicare |
$17,947.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,434.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,434.76
|
| Rate for Payer: BCBS MAPPO |
$17,947.81
|
| Rate for Payer: BCN Medicare Advantage |
$17,947.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,947.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,947.81
|
| Rate for Payer: Mclaren Medicare |
$17,947.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,845.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,639.98
|
| Rate for Payer: PACE Medicare |
$17,050.42
|
| Rate for Payer: PACE SWMI |
$17,947.81
|
| Rate for Payer: PHP Commercial |
$19,742.59
|
| Rate for Payer: PHP Medicare Advantage |
$17,947.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,051.33
|
| Rate for Payer: Priority Health Medicare |
$17,947.81
|
| Rate for Payer: Priority Health Narrow Network |
$20,041.06
|
| Rate for Payer: Railroad Medicare Medicare |
$17,947.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,947.81
|
| Rate for Payer: UHC Exchange |
$27,819.11
|
| Rate for Payer: UHC Medicare Advantage |
$17,947.81
|
| Rate for Payer: UHCCP DNSP |
$17,947.81
|
| Rate for Payer: VA VA |
$17,947.81
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$12,108.68
|
|
|
Service Code
|
MSDRG 921
|
| Min. Negotiated Rate |
$7,421.45 |
| Max. Negotiated Rate |
$12,108.68 |
| Rate for Payer: Aetna Medicare |
$7,812.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,765.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,765.06
|
| Rate for Payer: BCBS MAPPO |
$7,812.05
|
| Rate for Payer: BCN Medicare Advantage |
$7,812.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,812.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,812.05
|
| Rate for Payer: Mclaren Medicare |
$7,812.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,202.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,983.86
|
| Rate for Payer: PACE Medicare |
$7,421.45
|
| Rate for Payer: PACE SWMI |
$7,812.05
|
| Rate for Payer: PHP Commercial |
$8,593.26
|
| Rate for Payer: PHP Medicare Advantage |
$7,812.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,446.80
|
| Rate for Payer: Priority Health Medicare |
$7,812.05
|
| Rate for Payer: Priority Health Narrow Network |
$7,557.44
|
| Rate for Payer: Railroad Medicare Medicare |
$7,812.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,812.05
|
| Rate for Payer: UHC Exchange |
$12,108.68
|
| Rate for Payer: UHC Medicare Advantage |
$7,812.05
|
| Rate for Payer: UHCCP DNSP |
$7,812.05
|
| Rate for Payer: VA VA |
$7,812.05
|
|
|
MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES
|
Facility
|
IP
|
$153,269.01
|
|
|
Service Code
|
MSDRG 212
|
| Min. Negotiated Rate |
$93,939.07 |
| Max. Negotiated Rate |
$153,269.01 |
| Rate for Payer: Aetna Medicare |
$98,883.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123,604.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123,604.04
|
| Rate for Payer: BCBS MAPPO |
$98,883.23
|
| Rate for Payer: BCN Medicare Advantage |
$98,883.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98,883.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$98,883.23
|
| Rate for Payer: Mclaren Medicare |
$98,883.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103,827.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113,715.71
|
| Rate for Payer: PACE Medicare |
$93,939.07
|
| Rate for Payer: PACE SWMI |
$98,883.23
|
| Rate for Payer: PHP Commercial |
$108,771.55
|
| Rate for Payer: PHP Medicare Advantage |
$98,883.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149,658.12
|
| Rate for Payer: Priority Health Medicare |
$98,883.23
|
| Rate for Payer: Priority Health Narrow Network |
$119,726.50
|
| Rate for Payer: Railroad Medicare Medicare |
$98,883.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$98,883.23
|
| Rate for Payer: UHC Exchange |
$153,269.01
|
| Rate for Payer: UHC Medicare Advantage |
$98,883.23
|
| Rate for Payer: UHCCP DNSP |
$98,883.23
|
| Rate for Payer: VA VA |
$98,883.23
|
|
|
MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION
|
Facility
|
IP
|
$84,988.22
|
|
|
Service Code
|
MSDRG 317
|
| Min. Negotiated Rate |
$67,990.57 |
| Max. Negotiated Rate |
$84,988.22 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84,988.22
|
| Rate for Payer: Priority Health Narrow Network |
$67,990.57
|
|
