|
MS-DRG 42.00: PLEURAL EFFUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$12,751.82
|
|
|
Service Code
|
MSDRG 188
|
| Min. Negotiated Rate |
$7,815.63 |
| Max. Negotiated Rate |
$12,751.82 |
| Rate for Payer: Aetna Medicare |
$8,226.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,283.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,283.73
|
| Rate for Payer: BCBS MAPPO |
$8,226.98
|
| Rate for Payer: BCN Medicare Advantage |
$8,226.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,226.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,226.98
|
| Rate for Payer: Mclaren Medicare |
$8,226.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,638.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,461.03
|
| Rate for Payer: PACE Medicare |
$7,815.63
|
| Rate for Payer: PACE SWMI |
$8,226.98
|
| Rate for Payer: PHP Commercial |
$9,049.68
|
| Rate for Payer: PHP Medicare Advantage |
$8,226.98
|
| Rate for Payer: Priority Health Medicare |
$8,226.98
|
| Rate for Payer: Railroad Medicare Medicare |
$8,226.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,226.98
|
| Rate for Payer: UHC Exchange |
$12,751.82
|
| Rate for Payer: UHC Medicare Advantage |
$8,226.98
|
| Rate for Payer: UHCCP DNSP |
$8,226.98
|
| Rate for Payer: VA VA |
$8,226.98
|
|
|
MS-DRG 42.00: PNEUMOTHORAX WITH CC
|
Facility
|
IP
|
$17,914.87
|
|
|
Service Code
|
MSDRG 200
|
| Min. Negotiated Rate |
$10,980.08 |
| Max. Negotiated Rate |
$17,914.87 |
| Rate for Payer: Aetna Medicare |
$11,557.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,447.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,447.48
|
| Rate for Payer: BCBS MAPPO |
$11,557.98
|
| Rate for Payer: BCN Medicare Advantage |
$11,557.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,557.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,557.98
|
| Rate for Payer: Mclaren Medicare |
$11,557.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,135.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,291.68
|
| Rate for Payer: PACE Medicare |
$10,980.08
|
| Rate for Payer: PACE SWMI |
$11,557.98
|
| Rate for Payer: PHP Commercial |
$12,713.78
|
| Rate for Payer: PHP Medicare Advantage |
$11,557.98
|
| Rate for Payer: Priority Health Medicare |
$11,557.98
|
| Rate for Payer: Railroad Medicare Medicare |
$11,557.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,557.98
|
| Rate for Payer: UHC Exchange |
$17,914.87
|
| Rate for Payer: UHC Medicare Advantage |
$11,557.98
|
| Rate for Payer: UHCCP DNSP |
$11,557.98
|
| Rate for Payer: VA VA |
$11,557.98
|
|
|
MS-DRG 42.00: PNEUMOTHORAX WITH MCC
|
Facility
|
IP
|
$27,012.78
|
|
|
Service Code
|
MSDRG 199
|
| Min. Negotiated Rate |
$16,556.22 |
| Max. Negotiated Rate |
$27,012.78 |
| Rate for Payer: Aetna Medicare |
$17,427.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,784.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,784.50
|
| Rate for Payer: BCBS MAPPO |
$17,427.60
|
| Rate for Payer: BCN Medicare Advantage |
$17,427.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,427.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,427.60
|
| Rate for Payer: Mclaren Medicare |
$17,427.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,298.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,041.74
|
| Rate for Payer: PACE Medicare |
$16,556.22
|
| Rate for Payer: PACE SWMI |
$17,427.60
|
| Rate for Payer: PHP Commercial |
$19,170.36
|
| Rate for Payer: PHP Medicare Advantage |
$17,427.60
|
| Rate for Payer: Priority Health Medicare |
$17,427.60
|
| Rate for Payer: Railroad Medicare Medicare |
$17,427.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,427.60
|
| Rate for Payer: UHC Exchange |
$27,012.78
|
| Rate for Payer: UHC Medicare Advantage |
$17,427.60
|
| Rate for Payer: UHCCP DNSP |
$17,427.60
|
| Rate for Payer: VA VA |
$17,427.60
|
|
|
MS-DRG 42.00: PNEUMOTHORAX WITHOUT CC/MCC
|
Facility
|
IP
|
$11,962.06
|
|
|
Service Code
|
MSDRG 201
|
| Min. Negotiated Rate |
$7,331.59 |
| Max. Negotiated Rate |
$11,962.06 |
| Rate for Payer: Aetna Medicare |
$7,717.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,646.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,646.83
|
| Rate for Payer: BCBS MAPPO |
$7,717.46
|
| Rate for Payer: BCN Medicare Advantage |
$7,717.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,717.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,717.46
|
| Rate for Payer: Mclaren Medicare |
$7,717.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,103.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,875.08
|
| Rate for Payer: PACE Medicare |
$7,331.59
|
| Rate for Payer: PACE SWMI |
$7,717.46
|
| Rate for Payer: PHP Commercial |
$8,489.21
|
| Rate for Payer: PHP Medicare Advantage |
$7,717.46
|
| Rate for Payer: Priority Health Medicare |
$7,717.46
|
| Rate for Payer: Railroad Medicare Medicare |
$7,717.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,717.46
|
| Rate for Payer: UHC Exchange |
$11,962.06
|
| Rate for Payer: UHC Medicare Advantage |
$7,717.46
|
| Rate for Payer: UHCCP DNSP |
$7,717.46
|
| Rate for Payer: VA VA |
$7,717.46
|
|
|
MS-DRG 42.00: POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC
|
Facility
|
IP
|
$25,275.63
|
|
|
Service Code
|
MSDRG 917
|
| Min. Negotiated Rate |
$15,491.52 |
| Max. Negotiated Rate |
$25,275.63 |
| Rate for Payer: Aetna Medicare |
$16,306.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,383.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,383.58
|
| Rate for Payer: BCBS MAPPO |
$16,306.86
|
| Rate for Payer: BCN Medicare Advantage |
$16,306.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,306.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,306.86
|
| Rate for Payer: Mclaren Medicare |
$16,306.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,122.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,752.89
|
| Rate for Payer: PACE Medicare |
$15,491.52
|
| Rate for Payer: PACE SWMI |
$16,306.86
|
| Rate for Payer: PHP Commercial |
$17,937.55
|
| Rate for Payer: PHP Medicare Advantage |
$16,306.86
|
| Rate for Payer: Priority Health Medicare |
$16,306.86
|
| Rate for Payer: Railroad Medicare Medicare |
$16,306.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,306.86
|
| Rate for Payer: UHC Exchange |
$25,275.63
|
| Rate for Payer: UHC Medicare Advantage |
$16,306.86
|
| Rate for Payer: UHCCP DNSP |
$16,306.86
|
| Rate for Payer: VA VA |
$16,306.86
|
|
|
MS-DRG 42.00: POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC
|
Facility
|
IP
|
$14,831.97
|
|
|
Service Code
|
MSDRG 918
|
| Min. Negotiated Rate |
$9,090.56 |
| Max. Negotiated Rate |
$14,831.97 |
| Rate for Payer: Aetna Medicare |
$9,569.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,961.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,961.26
|
| Rate for Payer: BCBS MAPPO |
$9,569.01
|
| Rate for Payer: BCN Medicare Advantage |
$9,569.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,569.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,569.01
|
| Rate for Payer: Mclaren Medicare |
$9,569.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,047.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,004.36
|
| Rate for Payer: PACE Medicare |
$9,090.56
|
| Rate for Payer: PACE SWMI |
$9,569.01
|
| Rate for Payer: PHP Commercial |
$10,525.91
|
| Rate for Payer: PHP Medicare Advantage |
$9,569.01
|
| Rate for Payer: Priority Health Medicare |
$9,569.01
|
| Rate for Payer: Railroad Medicare Medicare |
$9,569.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,569.01
|
| Rate for Payer: UHC Exchange |
$14,831.97
|
| Rate for Payer: UHC Medicare Advantage |
$9,569.01
|
| Rate for Payer: UHCCP DNSP |
$9,569.01
|
| Rate for Payer: VA VA |
$9,569.01
|
|
|
MS-DRG 42.00: POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC
|
Facility
|
IP
|
$28,027.97
|
|
|
Service Code
|
MSDRG 862
|
| Min. Negotiated Rate |
$17,178.43 |
| Max. Negotiated Rate |
$28,027.97 |
| Rate for Payer: Aetna Medicare |
$18,082.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,603.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,603.20
|
| Rate for Payer: BCBS MAPPO |
$18,082.56
|
| Rate for Payer: BCN Medicare Advantage |
$18,082.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,082.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,082.56
|
| Rate for Payer: Mclaren Medicare |
$18,082.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,986.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,794.94
|
| Rate for Payer: PACE Medicare |
$17,178.43
|
| Rate for Payer: PACE SWMI |
$18,082.56
|
| Rate for Payer: PHP Commercial |
$19,890.82
|
| Rate for Payer: PHP Medicare Advantage |
$18,082.56
|
| Rate for Payer: Priority Health Medicare |
$18,082.56
|
| Rate for Payer: Railroad Medicare Medicare |
$18,082.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,082.56
|
| Rate for Payer: UHC Exchange |
$28,027.97
|
| Rate for Payer: UHC Medicare Advantage |
$18,082.56
|
| Rate for Payer: UHCCP DNSP |
$18,082.56
|
| Rate for Payer: VA VA |
$18,082.56
|
|
|
MS-DRG 42.00: POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC
|
Facility
|
IP
|
$16,426.65
|
|
|
Service Code
|
MSDRG 863
|
| Min. Negotiated Rate |
$10,067.95 |
| Max. Negotiated Rate |
$16,426.65 |
| Rate for Payer: Aetna Medicare |
$10,597.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,247.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,247.30
|
| Rate for Payer: BCBS MAPPO |
$10,597.84
|
| Rate for Payer: BCN Medicare Advantage |
$10,597.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,597.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,597.84
|
| Rate for Payer: Mclaren Medicare |
$10,597.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,127.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,187.52
|
| Rate for Payer: PACE Medicare |
$10,067.95
|
| Rate for Payer: PACE SWMI |
$10,597.84
|
| Rate for Payer: PHP Commercial |
$11,657.62
|
| Rate for Payer: PHP Medicare Advantage |
$10,597.84
|
| Rate for Payer: Priority Health Medicare |
$10,597.84
|
| Rate for Payer: Railroad Medicare Medicare |
$10,597.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,597.84
|
| Rate for Payer: UHC Exchange |
$16,426.65
|
| Rate for Payer: UHC Medicare Advantage |
$10,597.84
|
| Rate for Payer: UHCCP DNSP |
$10,597.84
|
| Rate for Payer: VA VA |
$10,597.84
|
|
|
MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$32,733.23
|
|
|
Service Code
|
MSDRG 857
|
| Min. Negotiated Rate |
$20,062.30 |
| Max. Negotiated Rate |
$32,733.23 |
| Rate for Payer: Aetna Medicare |
$21,118.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,397.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,397.76
|
| Rate for Payer: BCBS MAPPO |
$21,118.21
|
| Rate for Payer: BCN Medicare Advantage |
$21,118.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,118.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,118.21
|
| Rate for Payer: Mclaren Medicare |
$21,118.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,174.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,285.94
|
| Rate for Payer: PACE Medicare |
$20,062.30
|
| Rate for Payer: PACE SWMI |
$21,118.21
|
| Rate for Payer: PHP Commercial |
$23,230.03
|
| Rate for Payer: PHP Medicare Advantage |
$21,118.21
|
| Rate for Payer: Priority Health Medicare |
$21,118.21
|
| Rate for Payer: Railroad Medicare Medicare |
$21,118.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,118.21
|
| Rate for Payer: UHC Exchange |
$32,733.23
|
| Rate for Payer: UHC Medicare Advantage |
$21,118.21
|
| Rate for Payer: UHCCP DNSP |
$21,118.21
|
| Rate for Payer: VA VA |
$21,118.21
|
|
|
MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$64,996.43
|
|
|
Service Code
|
MSDRG 856
|
| Min. Negotiated Rate |
$39,836.52 |
| Max. Negotiated Rate |
$64,996.43 |
| Rate for Payer: Aetna Medicare |
$41,933.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52,416.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52,416.47
|
| Rate for Payer: BCBS MAPPO |
$41,933.18
|
| Rate for Payer: BCN Medicare Advantage |
$41,933.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41,933.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$41,933.18
|
| Rate for Payer: Mclaren Medicare |
$41,933.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44,029.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48,223.16
|
| Rate for Payer: PACE Medicare |
$39,836.52
|
| Rate for Payer: PACE SWMI |
$41,933.18
|
| Rate for Payer: PHP Commercial |
$46,126.50
|
| Rate for Payer: PHP Medicare Advantage |
$41,933.18
|
| Rate for Payer: Priority Health Medicare |
$41,933.18
|
| Rate for Payer: Railroad Medicare Medicare |
$41,933.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$41,933.18
|
| Rate for Payer: UHC Exchange |
$64,996.43
|
| Rate for Payer: UHC Medicare Advantage |
$41,933.18
|
| Rate for Payer: UHCCP DNSP |
$41,933.18
|
| Rate for Payer: VA VA |
$41,933.18
|
|
|
MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,416.85
|
|
|
Service Code
|
MSDRG 858
|
| Min. Negotiated Rate |
$12,513.55 |
| Max. Negotiated Rate |
$20,416.85 |
| Rate for Payer: Aetna Medicare |
$13,172.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,465.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,465.20
|
| Rate for Payer: BCBS MAPPO |
$13,172.16
|
| Rate for Payer: BCN Medicare Advantage |
$13,172.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,172.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,172.16
|
| Rate for Payer: Mclaren Medicare |
$13,172.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,830.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,147.98
|
| Rate for Payer: PACE Medicare |
$12,513.55
|
| Rate for Payer: PACE SWMI |
$13,172.16
|
| Rate for Payer: PHP Commercial |
$14,489.38
|
| Rate for Payer: PHP Medicare Advantage |
$13,172.16
|
| Rate for Payer: Priority Health Medicare |
$13,172.16
|
| Rate for Payer: Railroad Medicare Medicare |
$13,172.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,172.16
|
| Rate for Payer: UHC Exchange |
$20,416.85
|
| Rate for Payer: UHC Medicare Advantage |
$13,172.16
|
| Rate for Payer: UHCCP DNSP |
$13,172.16
|
| Rate for Payer: VA VA |
$13,172.16
|
|
|
MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES
|
Facility
|
IP
|
$21,815.15
|
|
|
Service Code
|
MSDRG 769
|
| Min. Negotiated Rate |
$13,370.58 |
| Max. Negotiated Rate |
$21,815.15 |
| Rate for Payer: Aetna Medicare |
$14,074.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,592.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,592.86
|
| Rate for Payer: BCBS MAPPO |
$14,074.29
|
| Rate for Payer: BCN Medicare Advantage |
$14,074.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,074.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,074.29
|
| Rate for Payer: Mclaren Medicare |
$14,074.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,778.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,185.43
|
| Rate for Payer: PACE Medicare |
$13,370.58
|
| Rate for Payer: PACE SWMI |
$14,074.29
|
| Rate for Payer: PHP Commercial |
$15,481.72
|
| Rate for Payer: PHP Medicare Advantage |
$14,074.29
|
| Rate for Payer: Priority Health Medicare |
$14,074.29
|
| Rate for Payer: Railroad Medicare Medicare |
$14,074.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,074.29
|
| Rate for Payer: UHC Exchange |
$21,815.15
|
| Rate for Payer: UHC Medicare Advantage |
$14,074.29
|
| Rate for Payer: UHCCP DNSP |
$14,074.29
|
| Rate for Payer: VA VA |
$14,074.29
|
|
|
MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES
|
Facility
|
IP
|
$12,465.53
|
|
|
Service Code
|
MSDRG 776
|
| Min. Negotiated Rate |
$7,640.17 |
| Max. Negotiated Rate |
$12,465.53 |
| Rate for Payer: Aetna Medicare |
$8,042.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,052.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,052.85
|
| Rate for Payer: BCBS MAPPO |
$8,042.28
|
| Rate for Payer: BCN Medicare Advantage |
$8,042.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,042.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,042.28
|
| Rate for Payer: Mclaren Medicare |
$8,042.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,444.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,248.62
|
| Rate for Payer: PACE Medicare |
$7,640.17
|
| Rate for Payer: PACE SWMI |
$8,042.28
|
| Rate for Payer: PHP Commercial |
$8,846.51
|
| Rate for Payer: PHP Medicare Advantage |
$8,042.28
|
| Rate for Payer: Priority Health Medicare |
$8,042.28
|
| Rate for Payer: Railroad Medicare Medicare |
$8,042.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,042.28
|
| Rate for Payer: UHC Exchange |
$12,465.53
|
| Rate for Payer: UHC Medicare Advantage |
$8,042.28
|
| Rate for Payer: UHCCP DNSP |
$8,042.28
|
| Rate for Payer: VA VA |
$8,042.28
|
|
|
MS-DRG 42.00: PREMATURITY WITH MAJOR PROBLEMS
|
Facility
|
IP
|
$58,749.03
|
|
|
Service Code
|
MSDRG 791
|
| Min. Negotiated Rate |
$36,007.47 |
| Max. Negotiated Rate |
$58,749.03 |
| Rate for Payer: Aetna Medicare |
$37,902.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47,378.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47,378.25
|
| Rate for Payer: BCBS MAPPO |
$37,902.60
|
| Rate for Payer: BCN Medicare Advantage |
$37,902.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37,902.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$37,902.60
|
| Rate for Payer: Mclaren Medicare |
$37,902.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39,797.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43,587.99
|
| Rate for Payer: PACE Medicare |
$36,007.47
|
| Rate for Payer: PACE SWMI |
$37,902.60
|
| Rate for Payer: PHP Commercial |
$41,692.86
|
| Rate for Payer: PHP Medicare Advantage |
$37,902.60
|
| Rate for Payer: Priority Health Medicare |
$37,902.60
|
| Rate for Payer: Railroad Medicare Medicare |
$37,902.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$37,902.60
|
| Rate for Payer: UHC Exchange |
$58,749.03
|
| Rate for Payer: UHC Medicare Advantage |
$37,902.60
|
| Rate for Payer: UHCCP DNSP |
$37,902.60
|
| Rate for Payer: VA VA |
$37,902.60
|
|
|
MS-DRG 42.00: PREMATURITY WITHOUT MAJOR PROBLEMS
|
Facility
|
IP
|
$36,478.63
|
|
|
Service Code
|
MSDRG 792
|
| Min. Negotiated Rate |
$22,357.87 |
| Max. Negotiated Rate |
$36,478.63 |
| Rate for Payer: Aetna Medicare |
$23,534.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,418.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,418.25
|
| Rate for Payer: BCBS MAPPO |
$23,534.60
|
| Rate for Payer: BCN Medicare Advantage |
$23,534.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,534.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$23,534.60
|
| Rate for Payer: Mclaren Medicare |
$23,534.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,711.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,064.79
|
| Rate for Payer: PACE Medicare |
$22,357.87
|
| Rate for Payer: PACE SWMI |
$23,534.60
|
| Rate for Payer: PHP Commercial |
$25,888.06
|
| Rate for Payer: PHP Medicare Advantage |
$23,534.60
|
| Rate for Payer: Priority Health Medicare |
$23,534.60
|
| Rate for Payer: Railroad Medicare Medicare |
$23,534.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,534.60
|
| Rate for Payer: UHC Exchange |
$36,478.63
|
| Rate for Payer: UHC Medicare Advantage |
$23,534.60
|
| Rate for Payer: UHCCP DNSP |
$23,534.60
|
| Rate for Payer: VA VA |
$23,534.60
|
|
|
MS-DRG 42.00: PROSTATECTOMY WITH CC
|
Facility
|
IP
|
$25,380.75
|
|
|
Service Code
|
MSDRG 666
|
| Min. Negotiated Rate |
$15,555.95 |
| Max. Negotiated Rate |
$25,380.75 |
| Rate for Payer: Aetna Medicare |
$16,374.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,468.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,468.35
|
| Rate for Payer: BCBS MAPPO |
$16,374.68
|
| Rate for Payer: BCN Medicare Advantage |
$16,374.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,374.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,374.68
|
| Rate for Payer: Mclaren Medicare |
$16,374.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,193.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,830.88
|
| Rate for Payer: PACE Medicare |
$15,555.95
|
| Rate for Payer: PACE SWMI |
$16,374.68
|
| Rate for Payer: PHP Commercial |
$18,012.15
|
| Rate for Payer: PHP Medicare Advantage |
$16,374.68
|
| Rate for Payer: Priority Health Medicare |
$16,374.68
|
| Rate for Payer: Railroad Medicare Medicare |
$16,374.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,374.68
|
| Rate for Payer: UHC Exchange |
$25,380.75
|
| Rate for Payer: UHC Medicare Advantage |
$16,374.68
|
| Rate for Payer: UHCCP DNSP |
$16,374.68
|
| Rate for Payer: VA VA |
$16,374.68
|
|
|
MS-DRG 42.00: PROSTATECTOMY WITH MCC
|
Facility
|
IP
|
$50,086.76
|
|
|
Service Code
|
MSDRG 665
|
| Min. Negotiated Rate |
$30,698.34 |
| Max. Negotiated Rate |
$50,086.76 |
| Rate for Payer: Aetna Medicare |
$32,314.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,392.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,392.55
|
| Rate for Payer: BCBS MAPPO |
$32,314.04
|
| Rate for Payer: BCN Medicare Advantage |
$32,314.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,314.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$32,314.04
|
| Rate for Payer: Mclaren Medicare |
$32,314.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33,929.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,161.15
|
| Rate for Payer: PACE Medicare |
$30,698.34
|
| Rate for Payer: PACE SWMI |
$32,314.04
|
| Rate for Payer: PHP Commercial |
$35,545.44
|
| Rate for Payer: PHP Medicare Advantage |
$32,314.04
|
| Rate for Payer: Priority Health Medicare |
$32,314.04
|
| Rate for Payer: Railroad Medicare Medicare |
$32,314.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,314.04
|
| Rate for Payer: UHC Exchange |
$50,086.76
|
| Rate for Payer: UHC Medicare Advantage |
$32,314.04
|
| Rate for Payer: UHCCP DNSP |
$32,314.04
|
| Rate for Payer: VA VA |
$32,314.04
|
|
|
MS-DRG 42.00: PROSTATECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$16,812.54
|
|
|
Service Code
|
MSDRG 667
|
| Min. Negotiated Rate |
$10,304.46 |
| Max. Negotiated Rate |
$16,812.54 |
| Rate for Payer: Aetna Medicare |
$10,846.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,558.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,558.50
|
| Rate for Payer: BCBS MAPPO |
$10,846.80
|
| Rate for Payer: BCN Medicare Advantage |
$10,846.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,846.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,846.80
|
| Rate for Payer: Mclaren Medicare |
$10,846.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,389.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,473.82
|
| Rate for Payer: PACE Medicare |
$10,304.46
|
| Rate for Payer: PACE SWMI |
$10,846.80
|
| Rate for Payer: PHP Commercial |
$11,931.48
|
| Rate for Payer: PHP Medicare Advantage |
$10,846.80
|
| Rate for Payer: Priority Health Medicare |
$10,846.80
|
| Rate for Payer: Railroad Medicare Medicare |
$10,846.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,846.80
|
| Rate for Payer: UHC Exchange |
$16,812.54
|
| Rate for Payer: UHC Medicare Advantage |
$10,846.80
|
| Rate for Payer: UHCCP DNSP |
$10,846.80
|
| Rate for Payer: VA VA |
$10,846.80
|
|
|
MS-DRG 42.00: PSYCHOSES
|
Facility
|
IP
|
$22,093.16
|
|
|
Service Code
|
MSDRG 885
|
| Min. Negotiated Rate |
$13,540.97 |
| Max. Negotiated Rate |
$22,093.16 |
| Rate for Payer: Aetna Medicare |
$14,253.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,817.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,817.06
|
| Rate for Payer: BCBS MAPPO |
$14,253.65
|
| Rate for Payer: BCN Medicare Advantage |
$14,253.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,253.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,253.65
|
| Rate for Payer: Mclaren Medicare |
$14,253.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,966.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,391.70
|
| Rate for Payer: PACE Medicare |
$13,540.97
|
| Rate for Payer: PACE SWMI |
$14,253.65
|
| Rate for Payer: PHP Commercial |
$15,679.01
|
| Rate for Payer: PHP Medicare Advantage |
$14,253.65
|
| Rate for Payer: Priority Health Medicare |
$14,253.65
|
| Rate for Payer: Railroad Medicare Medicare |
$14,253.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,253.65
|
| Rate for Payer: UHC Exchange |
$22,093.16
|
| Rate for Payer: UHC Medicare Advantage |
$14,253.65
|
| Rate for Payer: UHCCP DNSP |
$14,253.65
|
| Rate for Payer: VA VA |
$14,253.65
|
|
|
MS-DRG 42.00: PULMONARY EDEMA AND RESPIRATORY FAILURE
|
Facility
|
IP
|
$19,711.47
|
|
|
Service Code
|
MSDRG 189
|
| Min. Negotiated Rate |
$12,081.23 |
| Max. Negotiated Rate |
$19,711.47 |
| Rate for Payer: Aetna Medicare |
$12,717.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,896.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,896.35
|
| Rate for Payer: BCBS MAPPO |
$12,717.08
|
| Rate for Payer: BCN Medicare Advantage |
$12,717.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,717.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,717.08
|
| Rate for Payer: Mclaren Medicare |
$12,717.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,352.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,624.64
|
| Rate for Payer: PACE Medicare |
$12,081.23
|
| Rate for Payer: PACE SWMI |
$12,717.08
|
| Rate for Payer: PHP Commercial |
$13,988.79
|
| Rate for Payer: PHP Medicare Advantage |
$12,717.08
|
| Rate for Payer: Priority Health Medicare |
$12,717.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12,717.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,717.08
|
| Rate for Payer: UHC Exchange |
$19,711.47
|
| Rate for Payer: UHC Medicare Advantage |
$12,717.08
|
| Rate for Payer: UHCCP DNSP |
$12,717.08
|
| Rate for Payer: VA VA |
$12,717.08
|
|
|
MS-DRG 42.00: PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE
|
Facility
|
IP
|
$22,086.24
|
|
|
Service Code
|
MSDRG 175
|
| Min. Negotiated Rate |
$13,536.73 |
| Max. Negotiated Rate |
$22,086.24 |
| Rate for Payer: Aetna Medicare |
$14,249.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,811.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,811.49
|
| Rate for Payer: BCBS MAPPO |
$14,249.19
|
| Rate for Payer: BCN Medicare Advantage |
$14,249.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,249.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,249.19
|
| Rate for Payer: Mclaren Medicare |
$14,249.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,961.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,386.57
|
| Rate for Payer: PACE Medicare |
$13,536.73
|
| Rate for Payer: PACE SWMI |
$14,249.19
|
| Rate for Payer: PHP Commercial |
$15,674.11
|
| Rate for Payer: PHP Medicare Advantage |
$14,249.19
|
| Rate for Payer: Priority Health Medicare |
$14,249.19
|
| Rate for Payer: Railroad Medicare Medicare |
$14,249.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,249.19
|
| Rate for Payer: UHC Exchange |
$22,086.24
|
| Rate for Payer: UHC Medicare Advantage |
$14,249.19
|
| Rate for Payer: UHCCP DNSP |
$14,249.19
|
| Rate for Payer: VA VA |
$14,249.19
|
|
|
MS-DRG 42.00: PULMONARY EMBOLISM WITHOUT MCC
|
Facility
|
IP
|
$13,862.41
|
|
|
Service Code
|
MSDRG 176
|
| Min. Negotiated Rate |
$8,496.32 |
| Max. Negotiated Rate |
$13,862.41 |
| Rate for Payer: Aetna Medicare |
$8,943.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,179.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,179.36
|
| Rate for Payer: BCBS MAPPO |
$8,943.49
|
| Rate for Payer: BCN Medicare Advantage |
$8,943.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,943.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,943.49
|
| Rate for Payer: Mclaren Medicare |
$8,943.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,390.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,285.01
|
| Rate for Payer: PACE Medicare |
$8,496.32
|
| Rate for Payer: PACE SWMI |
$8,943.49
|
| Rate for Payer: PHP Commercial |
$9,837.84
|
| Rate for Payer: PHP Medicare Advantage |
$8,943.49
|
| Rate for Payer: Priority Health Medicare |
$8,943.49
|
| Rate for Payer: Railroad Medicare Medicare |
$8,943.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,943.49
|
| Rate for Payer: UHC Exchange |
$13,862.41
|
| Rate for Payer: UHC Medicare Advantage |
$8,943.49
|
| Rate for Payer: UHCCP DNSP |
$8,943.49
|
| Rate for Payer: VA VA |
$8,943.49
|
|
|
MS-DRG 42.00: RADIOTHERAPY
|
Facility
|
IP
|
$39,540.75
|
|
|
Service Code
|
MSDRG 849
|
| Min. Negotiated Rate |
$24,234.65 |
| Max. Negotiated Rate |
$39,540.75 |
| Rate for Payer: Aetna Medicare |
$25,510.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,887.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,887.70
|
| Rate for Payer: BCBS MAPPO |
$25,510.16
|
| Rate for Payer: BCN Medicare Advantage |
$25,510.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,510.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,510.16
|
| Rate for Payer: Mclaren Medicare |
$25,510.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,785.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,336.68
|
| Rate for Payer: PACE Medicare |
$24,234.65
|
| Rate for Payer: PACE SWMI |
$25,510.16
|
| Rate for Payer: PHP Commercial |
$28,061.18
|
| Rate for Payer: PHP Medicare Advantage |
$25,510.16
|
| Rate for Payer: Priority Health Medicare |
$25,510.16
|
| Rate for Payer: Railroad Medicare Medicare |
$25,510.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,510.16
|
| Rate for Payer: UHC Exchange |
$39,540.75
|
| Rate for Payer: UHC Medicare Advantage |
$25,510.16
|
| Rate for Payer: UHCCP DNSP |
$25,510.16
|
| Rate for Payer: VA VA |
$25,510.16
|
|
|
MS-DRG 42.00: RECTAL RESECTION WITH CC
|
Facility
|
IP
|
$31,991.86
|
|
|
Service Code
|
MSDRG 333
|
| Min. Negotiated Rate |
$19,607.91 |
| Max. Negotiated Rate |
$31,991.86 |
| Rate for Payer: Aetna Medicare |
$20,639.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,799.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,799.89
|
| Rate for Payer: BCBS MAPPO |
$20,639.91
|
| Rate for Payer: BCN Medicare Advantage |
$20,639.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,639.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,639.91
|
| Rate for Payer: Mclaren Medicare |
$20,639.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,671.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,735.90
|
| Rate for Payer: PACE Medicare |
$19,607.91
|
| Rate for Payer: PACE SWMI |
$20,639.91
|
| Rate for Payer: PHP Commercial |
$22,703.90
|
| Rate for Payer: PHP Medicare Advantage |
$20,639.91
|
| Rate for Payer: Priority Health Medicare |
$20,639.91
|
| Rate for Payer: Railroad Medicare Medicare |
$20,639.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,639.91
|
| Rate for Payer: UHC Exchange |
$31,991.86
|
| Rate for Payer: UHC Medicare Advantage |
$20,639.91
|
| Rate for Payer: UHCCP DNSP |
$20,639.91
|
| Rate for Payer: VA VA |
$20,639.91
|
|
|
MS-DRG 42.00: RECTAL RESECTION WITH MCC
|
Facility
|
IP
|
$50,572.24
|
|
|
Service Code
|
MSDRG 332
|
| Min. Negotiated Rate |
$30,995.89 |
| Max. Negotiated Rate |
$50,572.24 |
| Rate for Payer: Aetna Medicare |
$32,627.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,784.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,784.06
|
| Rate for Payer: BCBS MAPPO |
$32,627.25
|
| Rate for Payer: BCN Medicare Advantage |
$32,627.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,627.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$32,627.25
|
| Rate for Payer: Mclaren Medicare |
$32,627.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34,258.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,521.34
|
| Rate for Payer: PACE Medicare |
$30,995.89
|
| Rate for Payer: PACE SWMI |
$32,627.25
|
| Rate for Payer: PHP Commercial |
$35,889.97
|
| Rate for Payer: PHP Medicare Advantage |
$32,627.25
|
| Rate for Payer: Priority Health Medicare |
$32,627.25
|
| Rate for Payer: Railroad Medicare Medicare |
$32,627.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,627.25
|
| Rate for Payer: UHC Exchange |
$50,572.24
|
| Rate for Payer: UHC Medicare Advantage |
$32,627.25
|
| Rate for Payer: UHCCP DNSP |
$32,627.25
|
| Rate for Payer: VA VA |
$32,627.25
|
|
