|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$32,312.77
|
|
|
Service Code
|
MSDRG 141
|
| Min. Negotiated Rate |
$19,804.60 |
| Max. Negotiated Rate |
$32,312.77 |
| Rate for Payer: Aetna Medicare |
$20,846.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,058.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,058.69
|
| Rate for Payer: BCBS MAPPO |
$20,846.95
|
| Rate for Payer: BCN Medicare Advantage |
$20,846.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,846.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,846.95
|
| Rate for Payer: Mclaren Medicare |
$20,846.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,889.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,973.99
|
| Rate for Payer: PACE Medicare |
$19,804.60
|
| Rate for Payer: PACE SWMI |
$20,846.95
|
| Rate for Payer: PHP Commercial |
$22,931.65
|
| Rate for Payer: PHP Medicare Advantage |
$20,846.95
|
| Rate for Payer: Priority Health Medicare |
$20,846.95
|
| Rate for Payer: Railroad Medicare Medicare |
$20,846.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,846.95
|
| Rate for Payer: UHC Exchange |
$32,312.77
|
| Rate for Payer: UHC Medicare Advantage |
$20,846.95
|
| Rate for Payer: UHCCP DNSP |
$20,846.95
|
| Rate for Payer: VA VA |
$20,846.95
|
|
|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$61,090.60
|
|
|
Service Code
|
MSDRG 140
|
| Min. Negotiated Rate |
$37,442.63 |
| Max. Negotiated Rate |
$61,090.60 |
| Rate for Payer: Aetna Medicare |
$39,413.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49,266.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49,266.61
|
| Rate for Payer: BCBS MAPPO |
$39,413.29
|
| Rate for Payer: BCN Medicare Advantage |
$39,413.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39,413.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$39,413.29
|
| Rate for Payer: Mclaren Medicare |
$39,413.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41,383.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45,325.28
|
| Rate for Payer: PACE Medicare |
$37,442.63
|
| Rate for Payer: PACE SWMI |
$39,413.29
|
| Rate for Payer: PHP Commercial |
$43,354.62
|
| Rate for Payer: PHP Medicare Advantage |
$39,413.29
|
| Rate for Payer: Priority Health Medicare |
$39,413.29
|
| Rate for Payer: Railroad Medicare Medicare |
$39,413.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$39,413.29
|
| Rate for Payer: UHC Exchange |
$61,090.60
|
| Rate for Payer: UHC Medicare Advantage |
$39,413.29
|
| Rate for Payer: UHCCP DNSP |
$39,413.29
|
| Rate for Payer: VA VA |
$39,413.29
|
|
|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,344.83
|
|
|
Service Code
|
MSDRG 142
|
| Min. Negotiated Rate |
$14,921.02 |
| Max. Negotiated Rate |
$24,344.83 |
| Rate for Payer: Aetna Medicare |
$15,706.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,632.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,632.92
|
| Rate for Payer: BCBS MAPPO |
$15,706.34
|
| Rate for Payer: BCN Medicare Advantage |
$15,706.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,706.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,706.34
|
| Rate for Payer: Mclaren Medicare |
$15,706.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,491.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,062.29
|
| Rate for Payer: PACE Medicare |
$14,921.02
|
| Rate for Payer: PACE SWMI |
$15,706.34
|
| Rate for Payer: PHP Commercial |
$17,276.97
|
| Rate for Payer: PHP Medicare Advantage |
$15,706.34
|
| Rate for Payer: Priority Health Medicare |
$15,706.34
|
| Rate for Payer: Railroad Medicare Medicare |
$15,706.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,706.34
|
| Rate for Payer: UHC Exchange |
$24,344.83
|
| Rate for Payer: UHC Medicare Advantage |
$15,706.34
|
| Rate for Payer: UHCCP DNSP |
$15,706.34
|
| Rate for Payer: VA VA |
$15,706.34
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
|
IP
|
$19,726.69
|
|
|
Service Code
|
MSDRG 809
|
| Min. Negotiated Rate |
$12,090.56 |
| Max. Negotiated Rate |
$19,726.69 |
| Rate for Payer: Aetna Medicare |
$12,726.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,908.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,908.62
|
| Rate for Payer: BCBS MAPPO |
$12,726.90
|
| Rate for Payer: BCN Medicare Advantage |
$12,726.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,726.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,726.90
|
| Rate for Payer: Mclaren Medicare |
$12,726.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,363.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,635.93
|
| Rate for Payer: PACE Medicare |
$12,090.56
|
| Rate for Payer: PACE SWMI |
$12,726.90
|
| Rate for Payer: PHP Commercial |
$13,999.59
|
| Rate for Payer: PHP Medicare Advantage |
$12,726.90
|
| Rate for Payer: Priority Health Medicare |
$12,726.90
|
| Rate for Payer: Railroad Medicare Medicare |
$12,726.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,726.90
|
| Rate for Payer: UHC Exchange |
$19,726.69
|
| Rate for Payer: UHC Medicare Advantage |
$12,726.90
|
| Rate for Payer: UHCCP DNSP |
$12,726.90
|
| Rate for Payer: VA VA |
$12,726.90
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
|
IP
|
$34,273.99
|
|
|
Service Code
|
MSDRG 808
|
| Min. Negotiated Rate |
$21,006.64 |
| Max. Negotiated Rate |
$34,273.99 |
| Rate for Payer: Aetna Medicare |
$22,112.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,640.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,640.31
|
| Rate for Payer: BCBS MAPPO |
$22,112.25
|
| Rate for Payer: BCN Medicare Advantage |
$22,112.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,112.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,112.25
|
| Rate for Payer: Mclaren Medicare |
$22,112.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,217.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,429.09
|
| Rate for Payer: PACE Medicare |
$21,006.64
|
| Rate for Payer: PACE SWMI |
$22,112.25
|
| Rate for Payer: PHP Commercial |
$24,323.47
|
| Rate for Payer: PHP Medicare Advantage |
$22,112.25
|
| Rate for Payer: Priority Health Medicare |
$22,112.25
|
| Rate for Payer: Railroad Medicare Medicare |
$22,112.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,112.25
|
| Rate for Payer: UHC Exchange |
$34,273.99
|
| Rate for Payer: UHC Medicare Advantage |
$22,112.25
|
| Rate for Payer: UHCCP DNSP |
$22,112.25
|
| Rate for Payer: VA VA |
$22,112.25
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$15,761.41
|
|
|
Service Code
|
MSDRG 810
|
| Min. Negotiated Rate |
$9,660.22 |
| Max. Negotiated Rate |
$15,761.41 |
| Rate for Payer: Aetna Medicare |
$10,168.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,710.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,710.81
|
| Rate for Payer: BCBS MAPPO |
$10,168.65
|
| Rate for Payer: BCN Medicare Advantage |
$10,168.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,168.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,168.65
|
| Rate for Payer: Mclaren Medicare |
$10,168.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,677.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,693.95
|
| Rate for Payer: PACE Medicare |
$9,660.22
|
| Rate for Payer: PACE SWMI |
$10,168.65
|
| Rate for Payer: PHP Commercial |
$11,185.51
|
| Rate for Payer: PHP Medicare Advantage |
$10,168.65
|
| Rate for Payer: Priority Health Medicare |
$10,168.65
|
| Rate for Payer: Railroad Medicare Medicare |
$10,168.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,168.65
|
| Rate for Payer: UHC Exchange |
$15,761.41
|
| Rate for Payer: UHC Medicare Advantage |
$10,168.65
|
| Rate for Payer: UHCCP DNSP |
$10,168.65
|
| Rate for Payer: VA VA |
$10,168.65
|
|
|
MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$47,806.08
|
|
|
Service Code
|
MSDRG 469
|
| Min. Negotiated Rate |
$29,300.50 |
| Max. Negotiated Rate |
$47,806.08 |
| Rate for Payer: Aetna Medicare |
$30,842.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,553.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,553.29
|
| Rate for Payer: BCBS MAPPO |
$30,842.63
|
| Rate for Payer: BCN Medicare Advantage |
$30,842.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,842.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$30,842.63
|
| Rate for Payer: Mclaren Medicare |
$30,842.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,384.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,469.02
|
| Rate for Payer: PACE Medicare |
$29,300.50
|
| Rate for Payer: PACE SWMI |
$30,842.63
|
| Rate for Payer: PHP Commercial |
$33,926.89
|
| Rate for Payer: PHP Medicare Advantage |
$30,842.63
|
| Rate for Payer: Priority Health Medicare |
$30,842.63
|
| Rate for Payer: Railroad Medicare Medicare |
$30,842.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$30,842.63
|
| Rate for Payer: UHC Exchange |
$47,806.08
|
| Rate for Payer: UHC Medicare Advantage |
$30,842.63
|
| Rate for Payer: UHCCP DNSP |
$30,842.63
|
| Rate for Payer: VA VA |
$30,842.63
|
|
|
MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$28,675.25
|
|
|
Service Code
|
MSDRG 470
|
| Min. Negotiated Rate |
$17,575.15 |
| Max. Negotiated Rate |
$28,675.25 |
| Rate for Payer: Aetna Medicare |
$18,500.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,125.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,125.20
|
| Rate for Payer: BCBS MAPPO |
$18,500.16
|
| Rate for Payer: BCN Medicare Advantage |
$18,500.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,500.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,500.16
|
| Rate for Payer: Mclaren Medicare |
$18,500.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,425.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,275.18
|
| Rate for Payer: PACE Medicare |
$17,575.15
|
| Rate for Payer: PACE SWMI |
$18,500.16
|
| Rate for Payer: PHP Commercial |
$20,350.18
|
| Rate for Payer: PHP Medicare Advantage |
$18,500.16
|
| Rate for Payer: Priority Health Medicare |
$18,500.16
|
| Rate for Payer: Railroad Medicare Medicare |
$18,500.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,500.16
|
| Rate for Payer: UHC Exchange |
$28,675.25
|
| Rate for Payer: UHC Medicare Advantage |
$18,500.16
|
| Rate for Payer: UHCCP DNSP |
$18,500.16
|
| Rate for Payer: VA VA |
$18,500.16
|
|
|
MS-DRG 42.00: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$37,840.93
|
|
|
Service Code
|
MSDRG 483
|
| Min. Negotiated Rate |
$23,192.83 |
| Max. Negotiated Rate |
$37,840.93 |
| Rate for Payer: Aetna Medicare |
$24,413.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,516.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,516.88
|
| Rate for Payer: BCBS MAPPO |
$24,413.50
|
| Rate for Payer: BCN Medicare Advantage |
$24,413.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,413.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$24,413.50
|
| Rate for Payer: Mclaren Medicare |
$24,413.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,634.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,075.53
|
| Rate for Payer: PACE Medicare |
$23,192.83
|
| Rate for Payer: PACE SWMI |
$24,413.50
|
| Rate for Payer: PHP Commercial |
$26,854.85
|
| Rate for Payer: PHP Medicare Advantage |
$24,413.50
|
| Rate for Payer: Priority Health Medicare |
$24,413.50
|
| Rate for Payer: Railroad Medicare Medicare |
$24,413.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$24,413.50
|
| Rate for Payer: UHC Exchange |
$37,840.93
|
| Rate for Payer: UHC Medicare Advantage |
$24,413.50
|
| Rate for Payer: UHCCP DNSP |
$24,413.50
|
| Rate for Payer: VA VA |
$24,413.50
|
|
|
MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$29,437.31
|
|
|
Service Code
|
MSDRG 707
|
| Min. Negotiated Rate |
$18,042.22 |
| Max. Negotiated Rate |
$29,437.31 |
| Rate for Payer: Aetna Medicare |
$18,991.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,739.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,739.76
|
| Rate for Payer: BCBS MAPPO |
$18,991.81
|
| Rate for Payer: BCN Medicare Advantage |
$18,991.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,991.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,991.81
|
| Rate for Payer: Mclaren Medicare |
$18,991.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,941.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,840.58
|
| Rate for Payer: PACE Medicare |
$18,042.22
|
| Rate for Payer: PACE SWMI |
$18,991.81
|
| Rate for Payer: PHP Commercial |
$20,890.99
|
| Rate for Payer: PHP Medicare Advantage |
$18,991.81
|
| Rate for Payer: Priority Health Medicare |
$18,991.81
|
| Rate for Payer: Railroad Medicare Medicare |
$18,991.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,991.81
|
| Rate for Payer: UHC Exchange |
$29,437.31
|
| Rate for Payer: UHC Medicare Advantage |
$18,991.81
|
| Rate for Payer: UHCCP DNSP |
$18,991.81
|
| Rate for Payer: VA VA |
$18,991.81
|
|
|
MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$23,101.43
|
|
|
Service Code
|
MSDRG 708
|
| Min. Negotiated Rate |
$14,158.94 |
| Max. Negotiated Rate |
$23,101.43 |
| Rate for Payer: Aetna Medicare |
$14,904.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,630.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,630.19
|
| Rate for Payer: BCBS MAPPO |
$14,904.15
|
| Rate for Payer: BCN Medicare Advantage |
$14,904.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,904.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,904.15
|
| Rate for Payer: Mclaren Medicare |
$14,904.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,649.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,139.77
|
| Rate for Payer: PACE Medicare |
$14,158.94
|
| Rate for Payer: PACE SWMI |
$14,904.15
|
| Rate for Payer: PHP Commercial |
$16,394.56
|
| Rate for Payer: PHP Medicare Advantage |
$14,904.15
|
| Rate for Payer: Priority Health Medicare |
$14,904.15
|
| Rate for Payer: Railroad Medicare Medicare |
$14,904.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,904.15
|
| Rate for Payer: UHC Exchange |
$23,101.43
|
| Rate for Payer: UHC Medicare Advantage |
$14,904.15
|
| Rate for Payer: UHCCP DNSP |
$14,904.15
|
| Rate for Payer: VA VA |
$14,904.15
|
|
|
MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$29,404.14
|
|
|
Service Code
|
MSDRG 507
|
| Min. Negotiated Rate |
$18,021.89 |
| Max. Negotiated Rate |
$29,404.14 |
| Rate for Payer: Aetna Medicare |
$18,970.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,713.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,713.01
|
| Rate for Payer: BCBS MAPPO |
$18,970.41
|
| Rate for Payer: BCN Medicare Advantage |
$18,970.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,970.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,970.41
|
| Rate for Payer: Mclaren Medicare |
$18,970.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,918.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,815.97
|
| Rate for Payer: PACE Medicare |
$18,021.89
|
| Rate for Payer: PACE SWMI |
$18,970.41
|
| Rate for Payer: PHP Commercial |
$20,867.45
|
| Rate for Payer: PHP Medicare Advantage |
$18,970.41
|
| Rate for Payer: Priority Health Medicare |
$18,970.41
|
| Rate for Payer: Railroad Medicare Medicare |
$18,970.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,970.41
|
| Rate for Payer: UHC Exchange |
$29,404.14
|
| Rate for Payer: UHC Medicare Advantage |
$18,970.41
|
| Rate for Payer: UHCCP DNSP |
$18,970.41
|
| Rate for Payer: VA VA |
$18,970.41
|
|
|
MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,447.29
|
|
|
Service Code
|
MSDRG 508
|
| Min. Negotiated Rate |
$12,532.21 |
| Max. Negotiated Rate |
$20,447.29 |
| Rate for Payer: Aetna Medicare |
$13,191.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,489.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,489.75
|
| Rate for Payer: BCBS MAPPO |
$13,191.80
|
| Rate for Payer: BCN Medicare Advantage |
$13,191.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,191.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,191.80
|
| Rate for Payer: Mclaren Medicare |
$13,191.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,851.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,170.57
|
| Rate for Payer: PACE Medicare |
$12,532.21
|
| Rate for Payer: PACE SWMI |
$13,191.80
|
| Rate for Payer: PHP Commercial |
$14,510.98
|
| Rate for Payer: PHP Medicare Advantage |
$13,191.80
|
| Rate for Payer: Priority Health Medicare |
$13,191.80
|
| Rate for Payer: Railroad Medicare Medicare |
$13,191.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,191.80
|
| Rate for Payer: UHC Exchange |
$20,447.29
|
| Rate for Payer: UHC Medicare Advantage |
$13,191.80
|
| Rate for Payer: UHCCP DNSP |
$13,191.80
|
| Rate for Payer: VA VA |
$13,191.80
|
|
|
MS-DRG 42.00: MAJOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$31,850.81
|
|
|
Service Code
|
MSDRG 595
|
| Min. Negotiated Rate |
$19,521.46 |
| Max. Negotiated Rate |
$31,850.81 |
| Rate for Payer: Aetna Medicare |
$20,548.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,686.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,686.14
|
| Rate for Payer: BCBS MAPPO |
$20,548.91
|
| Rate for Payer: BCN Medicare Advantage |
$20,548.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,548.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,548.91
|
| Rate for Payer: Mclaren Medicare |
$20,548.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,576.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,631.25
|
| Rate for Payer: PACE Medicare |
$19,521.46
|
| Rate for Payer: PACE SWMI |
$20,548.91
|
| Rate for Payer: PHP Commercial |
$22,603.80
|
| Rate for Payer: PHP Medicare Advantage |
$20,548.91
|
| Rate for Payer: Priority Health Medicare |
$20,548.91
|
| Rate for Payer: Railroad Medicare Medicare |
$20,548.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,548.91
|
| Rate for Payer: UHC Exchange |
$31,850.81
|
| Rate for Payer: UHC Medicare Advantage |
$20,548.91
|
| Rate for Payer: UHCCP DNSP |
$20,548.91
|
| Rate for Payer: VA VA |
$20,548.91
|
|
|
MS-DRG 42.00: MAJOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$17,549.72
|
|
|
Service Code
|
MSDRG 596
|
| Min. Negotiated Rate |
$10,756.28 |
| Max. Negotiated Rate |
$17,549.72 |
| Rate for Payer: Aetna Medicare |
$11,322.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,153.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,153.00
|
| Rate for Payer: BCBS MAPPO |
$11,322.40
|
| Rate for Payer: BCN Medicare Advantage |
$11,322.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,322.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,322.40
|
| Rate for Payer: Mclaren Medicare |
$11,322.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,888.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,020.76
|
| Rate for Payer: PACE Medicare |
$10,756.28
|
| Rate for Payer: PACE SWMI |
$11,322.40
|
| Rate for Payer: PHP Commercial |
$12,454.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,322.40
|
| Rate for Payer: Priority Health Medicare |
$11,322.40
|
| Rate for Payer: Railroad Medicare Medicare |
$11,322.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,322.40
|
| Rate for Payer: UHC Exchange |
$17,549.72
|
| Rate for Payer: UHC Medicare Advantage |
$11,322.40
|
| Rate for Payer: UHCCP DNSP |
$11,322.40
|
| Rate for Payer: VA VA |
$11,322.40
|
|
|
MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$35,289.14
|
|
|
Service Code
|
MSDRG 330
|
| Min. Negotiated Rate |
$21,628.83 |
| Max. Negotiated Rate |
$35,289.14 |
| Rate for Payer: Aetna Medicare |
$22,767.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,458.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,458.99
|
| Rate for Payer: BCBS MAPPO |
$22,767.19
|
| Rate for Payer: BCN Medicare Advantage |
$22,767.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,767.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,767.19
|
| Rate for Payer: Mclaren Medicare |
$22,767.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,905.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,182.27
|
| Rate for Payer: PACE Medicare |
$21,628.83
|
| Rate for Payer: PACE SWMI |
$22,767.19
|
| Rate for Payer: PHP Commercial |
$25,043.91
|
| Rate for Payer: PHP Medicare Advantage |
$22,767.19
|
| Rate for Payer: Priority Health Medicare |
$22,767.19
|
| Rate for Payer: Railroad Medicare Medicare |
$22,767.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,767.19
|
| Rate for Payer: UHC Exchange |
$35,289.14
|
| Rate for Payer: UHC Medicare Advantage |
$22,767.19
|
| Rate for Payer: UHCCP DNSP |
$22,767.19
|
| Rate for Payer: VA VA |
$22,767.19
|
|
|
MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$66,107.04
|
|
|
Service Code
|
MSDRG 329
|
| Min. Negotiated Rate |
$40,517.21 |
| Max. Negotiated Rate |
$66,107.04 |
| Rate for Payer: Aetna Medicare |
$42,649.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53,312.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53,312.12
|
| Rate for Payer: BCBS MAPPO |
$42,649.70
|
| Rate for Payer: BCN Medicare Advantage |
$42,649.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42,649.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$42,649.70
|
| Rate for Payer: Mclaren Medicare |
$42,649.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44,782.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49,047.15
|
| Rate for Payer: PACE Medicare |
$40,517.21
|
| Rate for Payer: PACE SWMI |
$42,649.70
|
| Rate for Payer: PHP Commercial |
$46,914.67
|
| Rate for Payer: PHP Medicare Advantage |
$42,649.70
|
| Rate for Payer: Priority Health Medicare |
$42,649.70
|
| Rate for Payer: Railroad Medicare Medicare |
$42,649.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$42,649.70
|
| Rate for Payer: UHC Exchange |
$66,107.04
|
| Rate for Payer: UHC Medicare Advantage |
$42,649.70
|
| Rate for Payer: UHCCP DNSP |
$42,649.70
|
| Rate for Payer: VA VA |
$42,649.70
|
|
|
MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$25,431.92
|
|
|
Service Code
|
MSDRG 331
|
| Min. Negotiated Rate |
$15,587.31 |
| Max. Negotiated Rate |
$25,431.92 |
| Rate for Payer: Aetna Medicare |
$16,407.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,509.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,509.61
|
| Rate for Payer: BCBS MAPPO |
$16,407.69
|
| Rate for Payer: BCN Medicare Advantage |
$16,407.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,407.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,407.69
|
| Rate for Payer: Mclaren Medicare |
$16,407.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,228.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,868.84
|
| Rate for Payer: PACE Medicare |
$15,587.31
|
| Rate for Payer: PACE SWMI |
$16,407.69
|
| Rate for Payer: PHP Commercial |
$18,048.46
|
| Rate for Payer: PHP Medicare Advantage |
$16,407.69
|
| Rate for Payer: Priority Health Medicare |
$16,407.69
|
| Rate for Payer: Railroad Medicare Medicare |
$16,407.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,407.69
|
| Rate for Payer: UHC Exchange |
$25,431.92
|
| Rate for Payer: UHC Medicare Advantage |
$16,407.69
|
| Rate for Payer: UHCCP DNSP |
$16,407.69
|
| Rate for Payer: VA VA |
$16,407.69
|
|
|
MS-DRG 42.00: MAJOR THUMB OR JOINT PROCEDURES
|
Facility
|
IP
|
$23,331.00
|
|
|
Service Code
|
MSDRG 506
|
| Min. Negotiated Rate |
$14,299.65 |
| Max. Negotiated Rate |
$23,331.00 |
| Rate for Payer: Aetna Medicare |
$15,052.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,815.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,815.33
|
| Rate for Payer: BCBS MAPPO |
$15,052.26
|
| Rate for Payer: BCN Medicare Advantage |
$15,052.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,052.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,052.26
|
| Rate for Payer: Mclaren Medicare |
$15,052.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,804.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,310.10
|
| Rate for Payer: PACE Medicare |
$14,299.65
|
| Rate for Payer: PACE SWMI |
$15,052.26
|
| Rate for Payer: PHP Commercial |
$16,557.49
|
| Rate for Payer: PHP Medicare Advantage |
$15,052.26
|
| Rate for Payer: Priority Health Medicare |
$15,052.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15,052.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,052.26
|
| Rate for Payer: UHC Exchange |
$23,331.00
|
| Rate for Payer: UHC Medicare Advantage |
$15,052.26
|
| Rate for Payer: UHCCP DNSP |
$15,052.26
|
| Rate for Payer: VA VA |
$15,052.26
|
|
|
MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$17,950.83
|
|
|
Service Code
|
MSDRG 755
|
| Min. Negotiated Rate |
$11,002.12 |
| Max. Negotiated Rate |
$17,950.83 |
| Rate for Payer: Aetna Medicare |
$11,581.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,476.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,476.48
|
| Rate for Payer: BCBS MAPPO |
$11,581.18
|
| Rate for Payer: BCN Medicare Advantage |
$11,581.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,581.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,581.18
|
| Rate for Payer: Mclaren Medicare |
$11,581.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,160.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,318.36
|
| Rate for Payer: PACE Medicare |
$11,002.12
|
| Rate for Payer: PACE SWMI |
$11,581.18
|
| Rate for Payer: PHP Commercial |
$12,739.30
|
| Rate for Payer: PHP Medicare Advantage |
$11,581.18
|
| Rate for Payer: Priority Health Medicare |
$11,581.18
|
| Rate for Payer: Railroad Medicare Medicare |
$11,581.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,581.18
|
| Rate for Payer: UHC Exchange |
$17,950.83
|
| Rate for Payer: UHC Medicare Advantage |
$11,581.18
|
| Rate for Payer: UHCCP DNSP |
$11,581.18
|
| Rate for Payer: VA VA |
$11,581.18
|
|
|
MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$27,621.33
|
|
|
Service Code
|
MSDRG 754
|
| Min. Negotiated Rate |
$16,929.20 |
| Max. Negotiated Rate |
$27,621.33 |
| Rate for Payer: Aetna Medicare |
$17,820.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,275.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,275.26
|
| Rate for Payer: BCBS MAPPO |
$17,820.21
|
| Rate for Payer: BCN Medicare Advantage |
$17,820.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,820.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,820.21
|
| Rate for Payer: Mclaren Medicare |
$17,820.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,711.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,493.24
|
| Rate for Payer: PACE Medicare |
$16,929.20
|
| Rate for Payer: PACE SWMI |
$17,820.21
|
| Rate for Payer: PHP Commercial |
$19,602.23
|
| Rate for Payer: PHP Medicare Advantage |
$17,820.21
|
| Rate for Payer: Priority Health Medicare |
$17,820.21
|
| Rate for Payer: Railroad Medicare Medicare |
$17,820.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,820.21
|
| Rate for Payer: UHC Exchange |
$27,621.33
|
| Rate for Payer: UHC Medicare Advantage |
$17,820.21
|
| Rate for Payer: UHCCP DNSP |
$17,820.21
|
| Rate for Payer: VA VA |
$17,820.21
|
|
|
MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$15,805.66
|
|
|
Service Code
|
MSDRG 756
|
| Min. Negotiated Rate |
$9,687.34 |
| Max. Negotiated Rate |
$15,805.66 |
| Rate for Payer: Aetna Medicare |
$10,197.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,746.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,746.50
|
| Rate for Payer: BCBS MAPPO |
$10,197.20
|
| Rate for Payer: BCN Medicare Advantage |
$10,197.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,197.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,197.20
|
| Rate for Payer: Mclaren Medicare |
$10,197.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,707.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,726.78
|
| Rate for Payer: PACE Medicare |
$9,687.34
|
| Rate for Payer: PACE SWMI |
$10,197.20
|
| Rate for Payer: PHP Commercial |
$11,216.92
|
| Rate for Payer: PHP Medicare Advantage |
$10,197.20
|
| Rate for Payer: Priority Health Medicare |
$10,197.20
|
| Rate for Payer: Railroad Medicare Medicare |
$10,197.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,197.20
|
| Rate for Payer: UHC Exchange |
$15,805.66
|
| Rate for Payer: UHC Medicare Advantage |
$10,197.20
|
| Rate for Payer: UHCCP DNSP |
$10,197.20
|
| Rate for Payer: VA VA |
$10,197.20
|
|
|
MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$18,127.85
|
|
|
Service Code
|
MSDRG 723
|
| Min. Negotiated Rate |
$11,110.62 |
| Max. Negotiated Rate |
$18,127.85 |
| Rate for Payer: Aetna Medicare |
$11,695.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,619.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,619.24
|
| Rate for Payer: BCBS MAPPO |
$11,695.39
|
| Rate for Payer: BCN Medicare Advantage |
$11,695.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,695.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,695.39
|
| Rate for Payer: Mclaren Medicare |
$11,695.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,280.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,449.70
|
| Rate for Payer: PACE Medicare |
$11,110.62
|
| Rate for Payer: PACE SWMI |
$11,695.39
|
| Rate for Payer: PHP Commercial |
$12,864.93
|
| Rate for Payer: PHP Medicare Advantage |
$11,695.39
|
| Rate for Payer: Priority Health Medicare |
$11,695.39
|
| Rate for Payer: Railroad Medicare Medicare |
$11,695.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,695.39
|
| Rate for Payer: UHC Exchange |
$18,127.85
|
| Rate for Payer: UHC Medicare Advantage |
$11,695.39
|
| Rate for Payer: UHCCP DNSP |
$11,695.39
|
| Rate for Payer: VA VA |
$11,695.39
|
|
|
MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$26,509.34
|
|
|
Service Code
|
MSDRG 722
|
| Min. Negotiated Rate |
$16,247.66 |
| Max. Negotiated Rate |
$26,509.34 |
| Rate for Payer: Aetna Medicare |
$17,102.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,378.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,378.50
|
| Rate for Payer: BCBS MAPPO |
$17,102.80
|
| Rate for Payer: BCN Medicare Advantage |
$17,102.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,102.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,102.80
|
| Rate for Payer: Mclaren Medicare |
$17,102.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,957.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,668.22
|
| Rate for Payer: PACE Medicare |
$16,247.66
|
| Rate for Payer: PACE SWMI |
$17,102.80
|
| Rate for Payer: PHP Commercial |
$18,813.08
|
| Rate for Payer: PHP Medicare Advantage |
$17,102.80
|
| Rate for Payer: Priority Health Medicare |
$17,102.80
|
| Rate for Payer: Railroad Medicare Medicare |
$17,102.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,102.80
|
| Rate for Payer: UHC Exchange |
$26,509.34
|
| Rate for Payer: UHC Medicare Advantage |
$17,102.80
|
| Rate for Payer: UHCCP DNSP |
$17,102.80
|
| Rate for Payer: VA VA |
$17,102.80
|
|
|
MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$12,674.37
|
|
|
Service Code
|
MSDRG 724
|
| Min. Negotiated Rate |
$7,768.16 |
| Max. Negotiated Rate |
$12,674.37 |
| Rate for Payer: Aetna Medicare |
$8,177.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,221.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,221.26
|
| Rate for Payer: BCBS MAPPO |
$8,177.01
|
| Rate for Payer: BCN Medicare Advantage |
$8,177.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,177.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,177.01
|
| Rate for Payer: Mclaren Medicare |
$8,177.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,585.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,403.56
|
| Rate for Payer: PACE Medicare |
$7,768.16
|
| Rate for Payer: PACE SWMI |
$8,177.01
|
| Rate for Payer: PHP Commercial |
$8,994.71
|
| Rate for Payer: PHP Medicare Advantage |
$8,177.01
|
| Rate for Payer: Priority Health Medicare |
$8,177.01
|
| Rate for Payer: Railroad Medicare Medicare |
$8,177.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,177.01
|
| Rate for Payer: UHC Exchange |
$12,674.37
|
| Rate for Payer: UHC Medicare Advantage |
$8,177.01
|
| Rate for Payer: UHCCP DNSP |
$8,177.01
|
| Rate for Payer: VA VA |
$8,177.01
|
|
