|
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 |
$11,517.28
|
| Rate for Payer: PHP Medicare Advantage |
$10,470.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,539.59
|
| Rate for Payer: Priority Health Medicare |
$10,470.25
|
| Rate for Payer: Priority Health Narrow Network |
$10,831.67
|
| 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 HMO/PPO/Tiered Network |
$8,709.03
|
| Rate for Payer: Priority Health Medicare |
$7,331.98
|
| Rate for Payer: Priority Health Narrow Network |
$6,967.22
|
| 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 HMO/PPO/Tiered Network |
$20,983.27
|
| Rate for Payer: Priority Health Medicare |
$15,304.80
|
| Rate for Payer: Priority Health Narrow Network |
$16,786.62
|
| 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 HMO/PPO/Tiered Network |
$42,856.81
|
| Rate for Payer: Priority Health Medicare |
$29,512.19
|
| Rate for Payer: Priority Health Narrow Network |
$34,285.45
|
| 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 HMO/PPO/Tiered Network |
$14,835.16
|
| Rate for Payer: Priority Health Medicare |
$11,310.80
|
| Rate for Payer: Priority Health Narrow Network |
$11,868.12
|
| 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 HMO/PPO/Tiered Network |
$22,120.84
|
| Rate for Payer: Priority Health Medicare |
$16,044.51
|
| Rate for Payer: Priority Health Narrow Network |
$17,696.67
|
| 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 HMO/PPO/Tiered Network |
$11,874.44
|
| Rate for Payer: Priority Health Medicare |
$9,386.96
|
| Rate for Payer: Priority Health Narrow Network |
$9,499.56
|
| 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 HMO/PPO/Tiered Network |
$20,459.82
|
| Rate for Payer: Priority Health Medicare |
$14,959.48
|
| Rate for Payer: Priority Health Narrow Network |
$16,367.86
|
| 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 HMO/PPO/Tiered Network |
$37,017.82
|
| Rate for Payer: Priority Health Medicare |
$25,718.96
|
| Rate for Payer: Priority Health Narrow Network |
$29,614.26
|
| 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 HMO/PPO/Tiered Network |
$17,107.55
|
| Rate for Payer: Priority Health Medicare |
$12,787.58
|
| Rate for Payer: Priority Health Narrow Network |
$13,686.04
|
| 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 HMO/PPO/Tiered Network |
$18,246.50
|
| Rate for Payer: Priority Health Medicare |
$13,525.53
|
| Rate for Payer: Priority Health Narrow Network |
$14,597.20
|
| 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 HMO/PPO/Tiered Network |
$10,736.87
|
| Rate for Payer: Priority Health Medicare |
$8,648.13
|
| Rate for Payer: Priority Health Narrow Network |
$8,589.50
|
| 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 HMO/PPO/Tiered Network |
$19,213.71
|
| Rate for Payer: Priority Health Medicare |
$14,155.49
|
| Rate for Payer: Priority Health Narrow Network |
$15,370.97
|
| 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 HMO/PPO/Tiered Network |
$11,176.51
|
| Rate for Payer: Priority Health Medicare |
$8,934.56
|
| Rate for Payer: Priority Health Narrow Network |
$8,941.21
|
| 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
|
$97,527.62
|
|
|
Service Code
|
MSDRG 427
|
| Min. Negotiated Rate |
$78,022.10 |
| Max. Negotiated Rate |
$97,527.62 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97,527.62
|
| Rate for Payer: Priority Health Narrow Network |
$78,022.10
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$144,004.61
|
|
|
Service Code
|
MSDRG 426
|
| Min. Negotiated Rate |
$115,203.68 |
| Max. Negotiated Rate |
$144,004.61 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144,004.61
|
| Rate for Payer: Priority Health Narrow Network |
$115,203.68
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC
|
Facility
|
IP
|
$75,634.84
|
|
|
Service Code
|
MSDRG 428
|
| Min. Negotiated Rate |
$60,507.87 |
| Max. Negotiated Rate |
$75,634.84 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75,634.84
|
| Rate for Payer: Priority Health Narrow Network |
$60,507.87
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$92,107.66
|
|
|
Service Code
|
MSDRG 447
|
| Min. Negotiated Rate |
$73,686.13 |
| Max. Negotiated Rate |
$92,107.66 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92,107.66
|
| Rate for Payer: Priority Health Narrow Network |
$73,686.13
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$56,098.27
|
|
|
Service Code
|
MSDRG 448
|
| Min. Negotiated Rate |
$44,878.61 |
| Max. Negotiated Rate |
$56,098.27 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,098.27
|
| Rate for Payer: Priority Health Narrow Network |
$44,878.61
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC
|
Facility
|
IP
|
$19,520.62
|
|
|
Service Code
|
MSDRG 059
|
| Min. Negotiated Rate |
$11,964.25 |
| Max. Negotiated Rate |
$19,520.62 |
| Rate for Payer: Aetna Medicare |
$12,593.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,742.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,742.44
|
| Rate for Payer: BCBS MAPPO |
$12,593.95
|
| Rate for Payer: BCN Medicare Advantage |
$12,593.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,593.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,593.95
|
| Rate for Payer: Mclaren Medicare |
$12,593.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,223.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,483.04
|
| Rate for Payer: PACE Medicare |
$11,964.25
|
| Rate for Payer: PACE SWMI |
$12,593.95
|
| Rate for Payer: PHP Commercial |
$13,853.34
|
| Rate for Payer: PHP Medicare Advantage |
$12,593.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,809.42
|
| Rate for Payer: Priority Health Medicare |
$12,593.95
|
| Rate for Payer: Priority Health Narrow Network |
$13,447.54
|
| Rate for Payer: Railroad Medicare Medicare |
$12,593.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,593.95
|
| Rate for Payer: UHC Exchange |
$19,520.62
|
| Rate for Payer: UHC Medicare Advantage |
$12,593.95
|
| Rate for Payer: UHCCP DNSP |
$12,593.95
|
| Rate for Payer: VA VA |
$12,593.95
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC
|
Facility
|
IP
|
$28,127.54
|
|
|
Service Code
|
MSDRG 058
|
| Min. Negotiated Rate |
$17,239.46 |
| Max. Negotiated Rate |
$28,127.54 |
| Rate for Payer: Aetna Medicare |
$18,146.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,683.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,683.50
|
| Rate for Payer: BCBS MAPPO |
$18,146.80
|
| Rate for Payer: BCN Medicare Advantage |
$18,146.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,146.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,146.80
|
| Rate for Payer: Mclaren Medicare |
$18,146.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,054.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,868.82
|
| Rate for Payer: PACE Medicare |
$17,239.46
|
| Rate for Payer: PACE SWMI |
$18,146.80
|
| Rate for Payer: PHP Commercial |
$19,961.48
|
| Rate for Payer: PHP Medicare Advantage |
$18,146.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,357.70
|
| Rate for Payer: Priority Health Medicare |
$18,146.80
|
| Rate for Payer: Priority Health Narrow Network |
$20,286.16
|
| Rate for Payer: Railroad Medicare Medicare |
$18,146.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,146.80
|
| Rate for Payer: UHC Exchange |
$28,127.54
|
| Rate for Payer: UHC Medicare Advantage |
$18,146.80
|
| Rate for Payer: UHCCP DNSP |
$18,146.80
|
| Rate for Payer: VA VA |
$18,146.80
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC
|
Facility
|
IP
|
$14,939.85
|
|
|
Service Code
|
MSDRG 060
|
| Min. Negotiated Rate |
$9,156.68 |
| Max. Negotiated Rate |
$14,939.85 |
| Rate for Payer: Aetna Medicare |
$9,638.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,048.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,048.26
|
| Rate for Payer: BCBS MAPPO |
$9,638.61
|
| Rate for Payer: BCN Medicare Advantage |
$9,638.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,638.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,638.61
|
| Rate for Payer: Mclaren Medicare |
$9,638.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,120.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,084.40
|
| Rate for Payer: PACE Medicare |
$9,156.68
|
| Rate for Payer: PACE SWMI |
$9,638.61
|
| Rate for Payer: PHP Commercial |
$10,602.47
|
| Rate for Payer: PHP Medicare Advantage |
$9,638.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,260.51
|
| Rate for Payer: Priority Health Medicare |
$9,638.61
|
| Rate for Payer: Priority Health Narrow Network |
$9,808.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9,638.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,638.61
|
| Rate for Payer: UHC Exchange |
$14,939.85
|
| Rate for Payer: UHC Medicare Advantage |
$9,638.61
|
| Rate for Payer: UHCCP DNSP |
$9,638.61
|
| Rate for Payer: VA VA |
$9,638.61
|
|
|
MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$35,236.58
|
|
|
Service Code
|
MSDRG 827
|
| Min. Negotiated Rate |
$21,596.62 |
| Max. Negotiated Rate |
$35,236.58 |
| Rate for Payer: Aetna Medicare |
$22,733.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,416.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,416.60
|
| Rate for Payer: BCBS MAPPO |
$22,733.28
|
| Rate for Payer: BCN Medicare Advantage |
$22,733.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,733.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,733.28
|
| Rate for Payer: Mclaren Medicare |
$22,733.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,869.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,143.27
|
| Rate for Payer: PACE Medicare |
$21,596.62
|
| Rate for Payer: PACE SWMI |
$22,733.28
|
| Rate for Payer: PHP Commercial |
$25,006.61
|
| Rate for Payer: PHP Medicare Advantage |
$22,733.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,419.45
|
| Rate for Payer: Priority Health Medicare |
$22,733.28
|
| Rate for Payer: Priority Health Narrow Network |
$25,935.56
|
| Rate for Payer: Railroad Medicare Medicare |
$22,733.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,733.28
|
| Rate for Payer: UHC Exchange |
$35,236.58
|
| Rate for Payer: UHC Medicare Advantage |
$22,733.28
|
| Rate for Payer: UHCCP DNSP |
$22,733.28
|
| Rate for Payer: VA VA |
$22,733.28
|
|
|
MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$68,646.38
|
|
|
Service Code
|
MSDRG 826
|
| Min. Negotiated Rate |
$42,073.59 |
| Max. Negotiated Rate |
$68,646.38 |
| Rate for Payer: Aetna Medicare |
$44,287.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55,359.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55,359.99
|
| Rate for Payer: BCBS MAPPO |
$44,287.99
|
| Rate for Payer: BCN Medicare Advantage |
$44,287.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44,287.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$44,287.99
|
| Rate for Payer: Mclaren Medicare |
$44,287.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46,502.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50,931.19
|
| Rate for Payer: PACE Medicare |
$42,073.59
|
| Rate for Payer: PACE SWMI |
$44,287.99
|
| Rate for Payer: PHP Commercial |
$48,716.79
|
| Rate for Payer: PHP Medicare Advantage |
$44,287.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65,605.52
|
| Rate for Payer: Priority Health Medicare |
$44,287.99
|
| Rate for Payer: Priority Health Narrow Network |
$52,484.41
|
| Rate for Payer: Railroad Medicare Medicare |
$44,287.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$44,287.99
|
| Rate for Payer: UHC Exchange |
$68,646.38
|
| Rate for Payer: UHC Medicare Advantage |
$44,287.99
|
| Rate for Payer: UHCCP DNSP |
$44,287.99
|
| Rate for Payer: VA VA |
$44,287.99
|
|
|
MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,766.68
|
|
|
Service Code
|
MSDRG 828
|
| Min. Negotiated Rate |
$15,179.58 |
| Max. Negotiated Rate |
$24,766.68 |
| Rate for Payer: Aetna Medicare |
$15,978.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,973.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,973.12
|
| Rate for Payer: BCBS MAPPO |
$15,978.50
|
| Rate for Payer: BCN Medicare Advantage |
$15,978.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,978.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,978.50
|
| Rate for Payer: Mclaren Medicare |
$15,978.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,777.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,375.28
|
| Rate for Payer: PACE Medicare |
$15,179.58
|
| Rate for Payer: PACE SWMI |
$15,978.50
|
| Rate for Payer: PHP Commercial |
$17,576.35
|
| Rate for Payer: PHP Medicare Advantage |
$15,978.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,020.55
|
| Rate for Payer: Priority Health Medicare |
$15,978.50
|
| Rate for Payer: Priority Health Narrow Network |
$17,616.44
|
| Rate for Payer: Railroad Medicare Medicare |
$15,978.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,978.50
|
| Rate for Payer: UHC Exchange |
$24,766.68
|
| Rate for Payer: UHC Medicare Advantage |
$15,978.50
|
| Rate for Payer: UHCCP DNSP |
$15,978.50
|
| Rate for Payer: VA VA |
$15,978.50
|
|
