|
MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC
|
Facility
|
IP
|
$18,194.23
|
|
|
Service Code
|
MSDRG 436
|
| Min. Negotiated Rate |
$11,151.30 |
| Max. Negotiated Rate |
$18,194.23 |
| Rate for Payer: Aetna Medicare |
$11,738.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,672.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,672.76
|
| Rate for Payer: BCBS MAPPO |
$11,738.21
|
| Rate for Payer: BCN Medicare Advantage |
$11,738.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,738.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,738.21
|
| Rate for Payer: Mclaren Medicare |
$11,738.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,325.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,498.94
|
| Rate for Payer: PACE Medicare |
$11,151.30
|
| Rate for Payer: PACE SWMI |
$11,738.21
|
| Rate for Payer: PHP Commercial |
$12,912.03
|
| Rate for Payer: PHP Medicare Advantage |
$11,738.21
|
| Rate for Payer: Priority Health Medicare |
$11,738.21
|
| Rate for Payer: Railroad Medicare Medicare |
$11,738.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,738.21
|
| Rate for Payer: UHC Exchange |
$18,194.23
|
| Rate for Payer: UHC Medicare Advantage |
$11,738.21
|
| Rate for Payer: UHCCP DNSP |
$11,738.21
|
| Rate for Payer: VA VA |
$11,738.21
|
|
|
MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC
|
Facility
|
IP
|
$27,832.95
|
|
|
Service Code
|
MSDRG 435
|
| Min. Negotiated Rate |
$17,058.90 |
| Max. Negotiated Rate |
$27,832.95 |
| Rate for Payer: Aetna Medicare |
$17,956.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,445.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,445.92
|
| Rate for Payer: BCBS MAPPO |
$17,956.74
|
| Rate for Payer: BCN Medicare Advantage |
$17,956.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,956.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,956.74
|
| Rate for Payer: Mclaren Medicare |
$17,956.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,854.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,650.25
|
| Rate for Payer: PACE Medicare |
$17,058.90
|
| Rate for Payer: PACE SWMI |
$17,956.74
|
| Rate for Payer: PHP Commercial |
$19,752.41
|
| Rate for Payer: PHP Medicare Advantage |
$17,956.74
|
| Rate for Payer: Priority Health Medicare |
$17,956.74
|
| Rate for Payer: Railroad Medicare Medicare |
$17,956.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,956.74
|
| Rate for Payer: UHC Exchange |
$27,832.95
|
| Rate for Payer: UHC Medicare Advantage |
$17,956.74
|
| Rate for Payer: UHCCP DNSP |
$17,956.74
|
| Rate for Payer: VA VA |
$17,956.74
|
|
|
MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,457.16
|
|
|
Service Code
|
MSDRG 437
|
| Min. Negotiated Rate |
$8,247.94 |
| Max. Negotiated Rate |
$13,457.16 |
| Rate for Payer: Aetna Medicare |
$8,682.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,852.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,852.55
|
| Rate for Payer: BCBS MAPPO |
$8,682.04
|
| Rate for Payer: BCN Medicare Advantage |
$8,682.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,682.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,682.04
|
| Rate for Payer: Mclaren Medicare |
$8,682.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,116.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,984.35
|
| Rate for Payer: PACE Medicare |
$8,247.94
|
| Rate for Payer: PACE SWMI |
$8,682.04
|
| Rate for Payer: PHP Commercial |
$9,550.24
|
| Rate for Payer: PHP Medicare Advantage |
$8,682.04
|
| Rate for Payer: Priority Health Medicare |
$8,682.04
|
| Rate for Payer: Railroad Medicare Medicare |
$8,682.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,682.04
|
| Rate for Payer: UHC Exchange |
$13,457.16
|
| Rate for Payer: UHC Medicare Advantage |
$8,682.04
|
| Rate for Payer: UHCCP DNSP |
$8,682.04
|
| Rate for Payer: VA VA |
$8,682.04
|
|
|
MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH CC
|
Facility
|
IP
|
$17,519.28
|
|
|
Service Code
|
MSDRG 598
|
| Min. Negotiated Rate |
$10,737.62 |
| Max. Negotiated Rate |
$17,519.28 |
| Rate for Payer: Aetna Medicare |
$11,302.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,128.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,128.45
|
| Rate for Payer: BCBS MAPPO |
$11,302.76
|
| Rate for Payer: BCN Medicare Advantage |
$11,302.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,302.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,302.76
|
| Rate for Payer: Mclaren Medicare |
$11,302.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,867.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,998.17
|
| Rate for Payer: PACE Medicare |
$10,737.62
|
| Rate for Payer: PACE SWMI |
$11,302.76
|
| Rate for Payer: PHP Commercial |
$12,433.04
|
| Rate for Payer: PHP Medicare Advantage |
$11,302.76
|
| Rate for Payer: Priority Health Medicare |
$11,302.76
|
| Rate for Payer: Railroad Medicare Medicare |
$11,302.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,302.76
|
| Rate for Payer: UHC Exchange |
$17,519.28
|
| Rate for Payer: UHC Medicare Advantage |
$11,302.76
|
| Rate for Payer: UHCCP DNSP |
$11,302.76
|
| Rate for Payer: VA VA |
$11,302.76
|
|
|
MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH MCC
|
Facility
|
IP
|
$26,893.83
|
|
|
Service Code
|
MSDRG 597
|
| Min. Negotiated Rate |
$16,483.32 |
| Max. Negotiated Rate |
$26,893.83 |
| Rate for Payer: Aetna Medicare |
$17,350.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,688.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,688.58
|
| Rate for Payer: BCBS MAPPO |
$17,350.86
|
| Rate for Payer: BCN Medicare Advantage |
$17,350.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,350.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,350.86
|
| Rate for Payer: Mclaren Medicare |
$17,350.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,218.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,953.49
|
| Rate for Payer: PACE Medicare |
$16,483.32
|
| Rate for Payer: PACE SWMI |
$17,350.86
|
| Rate for Payer: PHP Commercial |
$19,085.95
|
| Rate for Payer: PHP Medicare Advantage |
$17,350.86
|
| Rate for Payer: Priority Health Medicare |
$17,350.86
|
| Rate for Payer: Railroad Medicare Medicare |
$17,350.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,350.86
|
| Rate for Payer: UHC Exchange |
$26,893.83
|
| Rate for Payer: UHC Medicare Advantage |
$17,350.86
|
| Rate for Payer: UHCCP DNSP |
$17,350.86
|
| Rate for Payer: VA VA |
$17,350.86
|
|
|
MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$14,421.18
|
|
|
Service Code
|
MSDRG 599
|
| Min. Negotiated Rate |
$8,838.79 |
| Max. Negotiated Rate |
$14,421.18 |
| Rate for Payer: Aetna Medicare |
$9,303.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,629.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,629.99
|
| Rate for Payer: BCBS MAPPO |
$9,303.99
|
| Rate for Payer: BCN Medicare Advantage |
$9,303.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,303.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,303.99
|
| Rate for Payer: Mclaren Medicare |
$9,303.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,769.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,699.59
|
| Rate for Payer: PACE Medicare |
$8,838.79
|
| Rate for Payer: PACE SWMI |
$9,303.99
|
| Rate for Payer: PHP Commercial |
$10,234.39
|
| Rate for Payer: PHP Medicare Advantage |
$9,303.99
|
| Rate for Payer: Priority Health Medicare |
$9,303.99
|
| Rate for Payer: Railroad Medicare Medicare |
$9,303.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,303.99
|
| Rate for Payer: UHC Exchange |
$14,421.18
|
| Rate for Payer: UHC Medicare Advantage |
$9,303.99
|
| Rate for Payer: UHCCP DNSP |
$9,303.99
|
| Rate for Payer: VA VA |
$9,303.99
|
|
|
MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$26,817.77
|
|
|
Service Code
|
MSDRG 582
|
| Min. Negotiated Rate |
$16,436.70 |
| Max. Negotiated Rate |
$26,817.77 |
| Rate for Payer: Aetna Medicare |
$17,301.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,627.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,627.24
|
| Rate for Payer: BCBS MAPPO |
$17,301.79
|
| Rate for Payer: BCN Medicare Advantage |
$17,301.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,301.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,301.79
|
| Rate for Payer: Mclaren Medicare |
$17,301.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,166.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,897.06
|
| Rate for Payer: PACE Medicare |
$16,436.70
|
| Rate for Payer: PACE SWMI |
$17,301.79
|
| Rate for Payer: PHP Commercial |
$19,031.97
|
| Rate for Payer: PHP Medicare Advantage |
$17,301.79
|
| Rate for Payer: Priority Health Medicare |
$17,301.79
|
| Rate for Payer: Railroad Medicare Medicare |
$17,301.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,301.79
|
| Rate for Payer: UHC Exchange |
$26,817.77
|
| Rate for Payer: UHC Medicare Advantage |
$17,301.79
|
| Rate for Payer: UHCCP DNSP |
$17,301.79
|
| Rate for Payer: VA VA |
$17,301.79
|
|
|
MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$25,317.13
|
|
|
Service Code
|
MSDRG 583
|
| Min. Negotiated Rate |
$15,516.95 |
| Max. Negotiated Rate |
$25,317.13 |
| Rate for Payer: Aetna Medicare |
$16,333.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,417.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,417.04
|
| Rate for Payer: BCBS MAPPO |
$16,333.63
|
| Rate for Payer: BCN Medicare Advantage |
$16,333.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,333.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,333.63
|
| Rate for Payer: Mclaren Medicare |
$16,333.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,150.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,783.67
|
| Rate for Payer: PACE Medicare |
$15,516.95
|
| Rate for Payer: PACE SWMI |
$16,333.63
|
| Rate for Payer: PHP Commercial |
$17,966.99
|
| Rate for Payer: PHP Medicare Advantage |
$16,333.63
|
| Rate for Payer: Priority Health Medicare |
$16,333.63
|
| Rate for Payer: Railroad Medicare Medicare |
$16,333.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,333.63
|
| Rate for Payer: UHC Exchange |
$25,317.13
|
| Rate for Payer: UHC Medicare Advantage |
$16,333.63
|
| Rate for Payer: UHCCP DNSP |
$16,333.63
|
| Rate for Payer: VA VA |
$16,333.63
|
|
|
MS-DRG 42.00: MEDICAL BACK PROBLEMS WITH MCC
|
Facility
|
IP
|
$26,198.15
|
|
|
Service Code
|
MSDRG 551
|
| Min. Negotiated Rate |
$16,056.93 |
| Max. Negotiated Rate |
$26,198.15 |
| Rate for Payer: Aetna Medicare |
$16,902.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,127.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,127.54
|
| Rate for Payer: BCBS MAPPO |
$16,902.03
|
| Rate for Payer: BCN Medicare Advantage |
$16,902.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,902.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,902.03
|
| Rate for Payer: Mclaren Medicare |
$16,902.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,747.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,437.33
|
| Rate for Payer: PACE Medicare |
$16,056.93
|
| Rate for Payer: PACE SWMI |
$16,902.03
|
| Rate for Payer: PHP Commercial |
$18,592.23
|
| Rate for Payer: PHP Medicare Advantage |
$16,902.03
|
| Rate for Payer: Priority Health Medicare |
$16,902.03
|
| Rate for Payer: Railroad Medicare Medicare |
$16,902.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,902.03
|
| Rate for Payer: UHC Exchange |
$26,198.15
|
| Rate for Payer: UHC Medicare Advantage |
$16,902.03
|
| Rate for Payer: UHCCP DNSP |
$16,902.03
|
| Rate for Payer: VA VA |
$16,902.03
|
|
|
MS-DRG 42.00: MEDICAL BACK PROBLEMS WITHOUT MCC
|
Facility
|
IP
|
$15,927.38
|
|
|
Service Code
|
MSDRG 552
|
| Min. Negotiated Rate |
$9,761.94 |
| Max. Negotiated Rate |
$15,927.38 |
| Rate for Payer: Aetna Medicare |
$10,275.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,844.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,844.66
|
| Rate for Payer: BCBS MAPPO |
$10,275.73
|
| Rate for Payer: BCN Medicare Advantage |
$10,275.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,275.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,275.73
|
| Rate for Payer: Mclaren Medicare |
$10,275.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,789.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,817.09
|
| Rate for Payer: PACE Medicare |
$9,761.94
|
| Rate for Payer: PACE SWMI |
$10,275.73
|
| Rate for Payer: PHP Commercial |
$11,303.30
|
| Rate for Payer: PHP Medicare Advantage |
$10,275.73
|
| Rate for Payer: Priority Health Medicare |
$10,275.73
|
| Rate for Payer: Railroad Medicare Medicare |
$10,275.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,275.73
|
| Rate for Payer: UHC Exchange |
$15,927.38
|
| Rate for Payer: UHC Medicare Advantage |
$10,275.73
|
| Rate for Payer: UHCCP DNSP |
$10,275.73
|
| Rate for Payer: VA VA |
$10,275.73
|
|
|
MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC
|
Facility
|
IP
|
$16,228.89
|
|
|
Service Code
|
MSDRG 760
|
| Min. Negotiated Rate |
$9,946.74 |
| Max. Negotiated Rate |
$16,228.89 |
| Rate for Payer: Aetna Medicare |
$10,470.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,087.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,087.81
|
| Rate for Payer: BCBS MAPPO |
$10,470.25
|
| Rate for Payer: BCN Medicare Advantage |
$10,470.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,470.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,470.25
|
| Rate for Payer: Mclaren Medicare |
$10,470.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,993.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,040.79
|
| Rate for Payer: PACE Medicare |
$9,946.74
|
| Rate for Payer: PACE SWMI |
$10,470.25
|
| Rate for Payer: PHP Commercial |
$11,517.27
|
| Rate for Payer: PHP Medicare Advantage |
$10,470.25
|
| Rate for Payer: Priority Health Medicare |
$10,470.25
|
| Rate for Payer: Railroad Medicare Medicare |
$10,470.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,470.25
|
| Rate for Payer: UHC Exchange |
$16,228.89
|
| Rate for Payer: UHC Medicare Advantage |
$10,470.25
|
| Rate for Payer: UHCCP DNSP |
$10,470.25
|
| Rate for Payer: VA VA |
$10,470.25
|
|
|
MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$11,364.57
|
|
|
Service Code
|
MSDRG 761
|
| Min. Negotiated Rate |
$6,965.38 |
| Max. Negotiated Rate |
$11,364.57 |
| Rate for Payer: Aetna Medicare |
$7,331.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,164.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,164.98
|
| Rate for Payer: BCBS MAPPO |
$7,331.98
|
| Rate for Payer: BCN Medicare Advantage |
$7,331.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,331.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,331.98
|
| Rate for Payer: Mclaren Medicare |
$7,331.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,698.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,431.78
|
| Rate for Payer: PACE Medicare |
$6,965.38
|
| Rate for Payer: PACE SWMI |
$7,331.98
|
| Rate for Payer: PHP Commercial |
$8,065.18
|
| Rate for Payer: PHP Medicare Advantage |
$7,331.98
|
| Rate for Payer: Priority Health Medicare |
$7,331.98
|
| Rate for Payer: Railroad Medicare Medicare |
$7,331.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,331.98
|
| Rate for Payer: UHC Exchange |
$11,364.57
|
| Rate for Payer: UHC Medicare Advantage |
$7,331.98
|
| Rate for Payer: UHCCP DNSP |
$7,331.98
|
| Rate for Payer: VA VA |
$7,331.98
|
|
|
MS-DRG 42.00: MINOR BLADDER PROCEDURES WITH CC
|
Facility
|
IP
|
$23,722.44
|
|
|
Service Code
|
MSDRG 663
|
| Min. Negotiated Rate |
$14,539.56 |
| Max. Negotiated Rate |
$23,722.44 |
| Rate for Payer: Aetna Medicare |
$15,304.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,131.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,131.00
|
| Rate for Payer: BCBS MAPPO |
$15,304.80
|
| Rate for Payer: BCN Medicare Advantage |
$15,304.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,304.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,304.80
|
| Rate for Payer: Mclaren Medicare |
$15,304.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,070.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,600.52
|
| Rate for Payer: PACE Medicare |
$14,539.56
|
| Rate for Payer: PACE SWMI |
$15,304.80
|
| Rate for Payer: PHP Commercial |
$16,835.28
|
| Rate for Payer: PHP Medicare Advantage |
$15,304.80
|
| Rate for Payer: Priority Health Medicare |
$15,304.80
|
| Rate for Payer: Railroad Medicare Medicare |
$15,304.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,304.80
|
| Rate for Payer: UHC Exchange |
$23,722.44
|
| Rate for Payer: UHC Medicare Advantage |
$15,304.80
|
| Rate for Payer: UHCCP DNSP |
$15,304.80
|
| Rate for Payer: VA VA |
$15,304.80
|
|
|
MS-DRG 42.00: MINOR BLADDER PROCEDURES WITH MCC
|
Facility
|
IP
|
$45,743.89
|
|
|
Service Code
|
MSDRG 662
|
| Min. Negotiated Rate |
$28,036.58 |
| Max. Negotiated Rate |
$45,743.89 |
| Rate for Payer: Aetna Medicare |
$29,512.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,890.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,890.24
|
| Rate for Payer: BCBS MAPPO |
$29,512.19
|
| Rate for Payer: BCN Medicare Advantage |
$29,512.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,512.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$29,512.19
|
| Rate for Payer: Mclaren Medicare |
$29,512.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,987.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,939.02
|
| Rate for Payer: PACE Medicare |
$28,036.58
|
| Rate for Payer: PACE SWMI |
$29,512.19
|
| Rate for Payer: PHP Commercial |
$32,463.41
|
| Rate for Payer: PHP Medicare Advantage |
$29,512.19
|
| Rate for Payer: Priority Health Medicare |
$29,512.19
|
| Rate for Payer: Railroad Medicare Medicare |
$29,512.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,512.19
|
| Rate for Payer: UHC Exchange |
$45,743.89
|
| Rate for Payer: UHC Medicare Advantage |
$29,512.19
|
| Rate for Payer: UHCCP DNSP |
$29,512.19
|
| Rate for Payer: VA VA |
$29,512.19
|
|
|
MS-DRG 42.00: MINOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$17,531.74
|
|
|
Service Code
|
MSDRG 664
|
| Min. Negotiated Rate |
$10,745.26 |
| Max. Negotiated Rate |
$17,531.74 |
| Rate for Payer: Aetna Medicare |
$11,310.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,138.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,138.50
|
| Rate for Payer: BCBS MAPPO |
$11,310.80
|
| Rate for Payer: BCN Medicare Advantage |
$11,310.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,310.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,310.80
|
| Rate for Payer: Mclaren Medicare |
$11,310.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,876.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,007.42
|
| Rate for Payer: PACE Medicare |
$10,745.26
|
| Rate for Payer: PACE SWMI |
$11,310.80
|
| Rate for Payer: PHP Commercial |
$12,441.88
|
| Rate for Payer: PHP Medicare Advantage |
$11,310.80
|
| Rate for Payer: Priority Health Medicare |
$11,310.80
|
| Rate for Payer: Railroad Medicare Medicare |
$11,310.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,310.80
|
| Rate for Payer: UHC Exchange |
$17,531.74
|
| Rate for Payer: UHC Medicare Advantage |
$11,310.80
|
| Rate for Payer: UHCCP DNSP |
$11,310.80
|
| Rate for Payer: VA VA |
$11,310.80
|
|
|
MS-DRG 42.00: MINOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$24,868.99
|
|
|
Service Code
|
MSDRG 606
|
| Min. Negotiated Rate |
$15,242.28 |
| Max. Negotiated Rate |
$24,868.99 |
| Rate for Payer: Aetna Medicare |
$16,044.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,055.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,055.64
|
| Rate for Payer: BCBS MAPPO |
$16,044.51
|
| Rate for Payer: BCN Medicare Advantage |
$16,044.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,044.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,044.51
|
| Rate for Payer: Mclaren Medicare |
$16,044.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,846.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,451.19
|
| Rate for Payer: PACE Medicare |
$15,242.28
|
| Rate for Payer: PACE SWMI |
$16,044.51
|
| Rate for Payer: PHP Commercial |
$17,648.96
|
| Rate for Payer: PHP Medicare Advantage |
$16,044.51
|
| Rate for Payer: Priority Health Medicare |
$16,044.51
|
| Rate for Payer: Railroad Medicare Medicare |
$16,044.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,044.51
|
| Rate for Payer: UHC Exchange |
$24,868.99
|
| Rate for Payer: UHC Medicare Advantage |
$16,044.51
|
| Rate for Payer: UHCCP DNSP |
$16,044.51
|
| Rate for Payer: VA VA |
$16,044.51
|
|
|
MS-DRG 42.00: MINOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$14,549.79
|
|
|
Service Code
|
MSDRG 607
|
| Min. Negotiated Rate |
$8,917.61 |
| Max. Negotiated Rate |
$14,549.79 |
| Rate for Payer: Aetna Medicare |
$9,386.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,733.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,733.70
|
| Rate for Payer: BCBS MAPPO |
$9,386.96
|
| Rate for Payer: BCN Medicare Advantage |
$9,386.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,386.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,386.96
|
| Rate for Payer: Mclaren Medicare |
$9,386.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,856.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,795.00
|
| Rate for Payer: PACE Medicare |
$8,917.61
|
| Rate for Payer: PACE SWMI |
$9,386.96
|
| Rate for Payer: PHP Commercial |
$10,325.66
|
| Rate for Payer: PHP Medicare Advantage |
$9,386.96
|
| Rate for Payer: Priority Health Medicare |
$9,386.96
|
| Rate for Payer: Railroad Medicare Medicare |
$9,386.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,386.96
|
| Rate for Payer: UHC Exchange |
$14,549.79
|
| Rate for Payer: UHC Medicare Advantage |
$9,386.96
|
| Rate for Payer: UHCCP DNSP |
$9,386.96
|
| Rate for Payer: VA VA |
$9,386.96
|
|
|
MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$23,187.19
|
|
|
Service Code
|
MSDRG 345
|
| Min. Negotiated Rate |
$14,211.51 |
| Max. Negotiated Rate |
$23,187.19 |
| Rate for Payer: Aetna Medicare |
$14,959.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,699.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,699.35
|
| Rate for Payer: BCBS MAPPO |
$14,959.48
|
| Rate for Payer: BCN Medicare Advantage |
$14,959.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,959.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,959.48
|
| Rate for Payer: Mclaren Medicare |
$14,959.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,707.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,203.40
|
| Rate for Payer: PACE Medicare |
$14,211.51
|
| Rate for Payer: PACE SWMI |
$14,959.48
|
| Rate for Payer: PHP Commercial |
$16,455.43
|
| Rate for Payer: PHP Medicare Advantage |
$14,959.48
|
| Rate for Payer: Priority Health Medicare |
$14,959.48
|
| Rate for Payer: Railroad Medicare Medicare |
$14,959.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,959.48
|
| Rate for Payer: UHC Exchange |
$23,187.19
|
| Rate for Payer: UHC Medicare Advantage |
$14,959.48
|
| Rate for Payer: UHCCP DNSP |
$14,959.48
|
| Rate for Payer: VA VA |
$14,959.48
|
|
|
MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$39,864.39
|
|
|
Service Code
|
MSDRG 344
|
| Min. Negotiated Rate |
$24,433.01 |
| Max. Negotiated Rate |
$39,864.39 |
| Rate for Payer: Aetna Medicare |
$25,718.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,148.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,148.70
|
| Rate for Payer: BCBS MAPPO |
$25,718.96
|
| Rate for Payer: BCN Medicare Advantage |
$25,718.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,718.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,718.96
|
| Rate for Payer: Mclaren Medicare |
$25,718.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,004.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,576.80
|
| Rate for Payer: PACE Medicare |
$24,433.01
|
| Rate for Payer: PACE SWMI |
$25,718.96
|
| Rate for Payer: PHP Commercial |
$28,290.86
|
| Rate for Payer: PHP Medicare Advantage |
$25,718.96
|
| Rate for Payer: Priority Health Medicare |
$25,718.96
|
| Rate for Payer: Railroad Medicare Medicare |
$25,718.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,718.96
|
| Rate for Payer: UHC Exchange |
$39,864.39
|
| Rate for Payer: UHC Medicare Advantage |
$25,718.96
|
| Rate for Payer: UHCCP DNSP |
$25,718.96
|
| Rate for Payer: VA VA |
$25,718.96
|
|
|
MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,820.75
|
|
|
Service Code
|
MSDRG 346
|
| Min. Negotiated Rate |
$12,148.20 |
| Max. Negotiated Rate |
$19,820.75 |
| Rate for Payer: Aetna Medicare |
$12,787.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,984.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,984.48
|
| Rate for Payer: BCBS MAPPO |
$12,787.58
|
| Rate for Payer: BCN Medicare Advantage |
$12,787.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,787.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,787.58
|
| Rate for Payer: Mclaren Medicare |
$12,787.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,426.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,705.72
|
| Rate for Payer: PACE Medicare |
$12,148.20
|
| Rate for Payer: PACE SWMI |
$12,787.58
|
| Rate for Payer: PHP Commercial |
$14,066.34
|
| Rate for Payer: PHP Medicare Advantage |
$12,787.58
|
| Rate for Payer: Priority Health Medicare |
$12,787.58
|
| Rate for Payer: Railroad Medicare Medicare |
$12,787.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,787.58
|
| Rate for Payer: UHC Exchange |
$19,820.75
|
| Rate for Payer: UHC Medicare Advantage |
$12,787.58
|
| Rate for Payer: UHCCP DNSP |
$12,787.58
|
| Rate for Payer: VA VA |
$12,787.58
|
|
|
MS-DRG 42.00: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC
|
Facility
|
IP
|
$20,964.57
|
|
|
Service Code
|
MSDRG 640
|
| Min. Negotiated Rate |
$12,849.25 |
| Max. Negotiated Rate |
$20,964.57 |
| Rate for Payer: Aetna Medicare |
$13,525.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,906.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,906.91
|
| Rate for Payer: BCBS MAPPO |
$13,525.53
|
| Rate for Payer: BCN Medicare Advantage |
$13,525.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,525.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,525.53
|
| Rate for Payer: Mclaren Medicare |
$13,525.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,201.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,554.36
|
| Rate for Payer: PACE Medicare |
$12,849.25
|
| Rate for Payer: PACE SWMI |
$13,525.53
|
| Rate for Payer: PHP Commercial |
$14,878.08
|
| Rate for Payer: PHP Medicare Advantage |
$13,525.53
|
| Rate for Payer: Priority Health Medicare |
$13,525.53
|
| Rate for Payer: Railroad Medicare Medicare |
$13,525.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,525.53
|
| Rate for Payer: UHC Exchange |
$20,964.57
|
| Rate for Payer: UHC Medicare Advantage |
$13,525.53
|
| Rate for Payer: UHCCP DNSP |
$13,525.53
|
| Rate for Payer: VA VA |
$13,525.53
|
|
|
MS-DRG 42.00: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC
|
Facility
|
IP
|
$13,404.60
|
|
|
Service Code
|
MSDRG 641
|
| Min. Negotiated Rate |
$8,215.72 |
| Max. Negotiated Rate |
$13,404.60 |
| Rate for Payer: Aetna Medicare |
$8,648.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,810.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,810.16
|
| Rate for Payer: BCBS MAPPO |
$8,648.13
|
| Rate for Payer: BCN Medicare Advantage |
$8,648.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,648.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,648.13
|
| Rate for Payer: Mclaren Medicare |
$8,648.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,080.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,945.35
|
| Rate for Payer: PACE Medicare |
$8,215.72
|
| Rate for Payer: PACE SWMI |
$8,648.13
|
| Rate for Payer: PHP Commercial |
$9,512.94
|
| Rate for Payer: PHP Medicare Advantage |
$8,648.13
|
| Rate for Payer: Priority Health Medicare |
$8,648.13
|
| Rate for Payer: Railroad Medicare Medicare |
$8,648.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,648.13
|
| Rate for Payer: UHC Exchange |
$13,404.60
|
| Rate for Payer: UHC Medicare Advantage |
$8,648.13
|
| Rate for Payer: UHCCP DNSP |
$8,648.13
|
| Rate for Payer: VA VA |
$8,648.13
|
|
|
MS-DRG 42.00: MOUTH PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$21,941.01
|
|
|
Service Code
|
MSDRG 137
|
| Min. Negotiated Rate |
$13,447.72 |
| Max. Negotiated Rate |
$21,941.01 |
| Rate for Payer: Aetna Medicare |
$14,155.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,694.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,694.36
|
| Rate for Payer: BCBS MAPPO |
$14,155.49
|
| Rate for Payer: BCN Medicare Advantage |
$14,155.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,155.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,155.49
|
| Rate for Payer: Mclaren Medicare |
$14,155.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,863.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,278.81
|
| Rate for Payer: PACE Medicare |
$13,447.72
|
| Rate for Payer: PACE SWMI |
$14,155.49
|
| Rate for Payer: PHP Commercial |
$15,571.04
|
| Rate for Payer: PHP Medicare Advantage |
$14,155.49
|
| Rate for Payer: Priority Health Medicare |
$14,155.49
|
| Rate for Payer: Railroad Medicare Medicare |
$14,155.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,155.49
|
| Rate for Payer: UHC Exchange |
$21,941.01
|
| Rate for Payer: UHC Medicare Advantage |
$14,155.49
|
| Rate for Payer: UHCCP DNSP |
$14,155.49
|
| Rate for Payer: VA VA |
$14,155.49
|
|
|
MS-DRG 42.00: MOUTH PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$13,848.57
|
|
|
Service Code
|
MSDRG 138
|
| Min. Negotiated Rate |
$8,487.83 |
| Max. Negotiated Rate |
$13,848.57 |
| Rate for Payer: Aetna Medicare |
$8,934.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,168.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,168.20
|
| Rate for Payer: BCBS MAPPO |
$8,934.56
|
| Rate for Payer: BCN Medicare Advantage |
$8,934.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,934.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,934.56
|
| Rate for Payer: Mclaren Medicare |
$8,934.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,381.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,274.74
|
| Rate for Payer: PACE Medicare |
$8,487.83
|
| Rate for Payer: PACE SWMI |
$8,934.56
|
| Rate for Payer: PHP Commercial |
$9,828.02
|
| Rate for Payer: PHP Medicare Advantage |
$8,934.56
|
| Rate for Payer: Priority Health Medicare |
$8,934.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8,934.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,934.56
|
| Rate for Payer: UHC Exchange |
$13,848.57
|
| Rate for Payer: UHC Medicare Advantage |
$8,934.56
|
| Rate for Payer: UHCCP DNSP |
$8,934.56
|
| Rate for Payer: VA VA |
$8,934.56
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC
|
Facility
|
IP
|
$100,833.53
|
|
|
Service Code
|
MSDRG 427
|
| Min. Negotiated Rate |
$61,801.20 |
| Max. Negotiated Rate |
$100,833.53 |
| Rate for Payer: Aetna Medicare |
$65,053.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81,317.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81,317.36
|
| Rate for Payer: BCBS MAPPO |
$65,053.89
|
| Rate for Payer: BCN Medicare Advantage |
$65,053.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65,053.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$65,053.89
|
| Rate for Payer: Mclaren Medicare |
$65,053.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68,306.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74,811.97
|
| Rate for Payer: PACE Medicare |
$61,801.20
|
| Rate for Payer: PACE SWMI |
$65,053.89
|
| Rate for Payer: PHP Commercial |
$71,559.28
|
| Rate for Payer: PHP Medicare Advantage |
$65,053.89
|
| Rate for Payer: Priority Health Medicare |
$65,053.89
|
| Rate for Payer: Railroad Medicare Medicare |
$65,053.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$65,053.89
|
| Rate for Payer: UHC Exchange |
$100,833.53
|
| Rate for Payer: UHC Medicare Advantage |
$65,053.89
|
| Rate for Payer: UHCCP DNSP |
$65,053.89
|
| Rate for Payer: VA VA |
$65,053.89
|
|
