|
MS-DRG 42.00: SEIZURES WITHOUT MCC
|
Facility
|
IP
|
$15,345.09
|
|
|
Service Code
|
MSDRG 101
|
| Min. Negotiated Rate |
$9,405.06 |
| Max. Negotiated Rate |
$15,345.09 |
| Rate for Payer: Aetna Medicare |
$9,900.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,375.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,375.08
|
| Rate for Payer: BCBS MAPPO |
$9,900.06
|
| Rate for Payer: BCN Medicare Advantage |
$9,900.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,900.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,900.06
|
| Rate for Payer: Mclaren Medicare |
$9,900.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,395.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,385.07
|
| Rate for Payer: PACE Medicare |
$9,405.06
|
| Rate for Payer: PACE SWMI |
$9,900.06
|
| Rate for Payer: PHP Commercial |
$10,890.07
|
| Rate for Payer: PHP Medicare Advantage |
$9,900.06
|
| Rate for Payer: Priority Health Medicare |
$9,900.06
|
| Rate for Payer: Railroad Medicare Medicare |
$9,900.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,900.06
|
| Rate for Payer: UHC Exchange |
$15,345.09
|
| Rate for Payer: UHC Medicare Advantage |
$9,900.06
|
| Rate for Payer: UHCCP DNSP |
$9,900.06
|
| Rate for Payer: VA VA |
$9,900.06
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITH CC
|
Facility
|
IP
|
$19,264.73
|
|
|
Service Code
|
MSDRG 549
|
| Min. Negotiated Rate |
$11,807.42 |
| Max. Negotiated Rate |
$19,264.73 |
| Rate for Payer: Aetna Medicare |
$12,428.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,536.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,536.08
|
| Rate for Payer: BCBS MAPPO |
$12,428.86
|
| Rate for Payer: BCN Medicare Advantage |
$12,428.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,428.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,428.86
|
| Rate for Payer: Mclaren Medicare |
$12,428.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,050.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,293.19
|
| Rate for Payer: PACE Medicare |
$11,807.42
|
| Rate for Payer: PACE SWMI |
$12,428.86
|
| Rate for Payer: PHP Commercial |
$13,671.75
|
| Rate for Payer: PHP Medicare Advantage |
$12,428.86
|
| Rate for Payer: Priority Health Medicare |
$12,428.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12,428.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,428.86
|
| Rate for Payer: UHC Exchange |
$19,264.73
|
| Rate for Payer: UHC Medicare Advantage |
$12,428.86
|
| Rate for Payer: UHCCP DNSP |
$12,428.86
|
| Rate for Payer: VA VA |
$12,428.86
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITH MCC
|
Facility
|
IP
|
$30,460.82
|
|
|
Service Code
|
MSDRG 548
|
| Min. Negotiated Rate |
$18,669.53 |
| Max. Negotiated Rate |
$30,460.82 |
| Rate for Payer: Aetna Medicare |
$19,652.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,565.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,565.17
|
| Rate for Payer: BCBS MAPPO |
$19,652.14
|
| Rate for Payer: BCN Medicare Advantage |
$19,652.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,652.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,652.14
|
| Rate for Payer: Mclaren Medicare |
$19,652.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,634.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,599.96
|
| Rate for Payer: PACE Medicare |
$18,669.53
|
| Rate for Payer: PACE SWMI |
$19,652.14
|
| Rate for Payer: PHP Commercial |
$21,617.35
|
| Rate for Payer: PHP Medicare Advantage |
$19,652.14
|
| Rate for Payer: Priority Health Medicare |
$19,652.14
|
| Rate for Payer: Railroad Medicare Medicare |
$19,652.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,652.14
|
| Rate for Payer: UHC Exchange |
$30,460.82
|
| Rate for Payer: UHC Medicare Advantage |
$19,652.14
|
| Rate for Payer: UHCCP DNSP |
$19,652.14
|
| Rate for Payer: VA VA |
$19,652.14
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$14,520.76
|
|
|
Service Code
|
MSDRG 550
|
| Min. Negotiated Rate |
$8,899.82 |
| Max. Negotiated Rate |
$14,520.76 |
| Rate for Payer: Aetna Medicare |
$9,368.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,710.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,710.29
|
| Rate for Payer: BCBS MAPPO |
$9,368.23
|
| Rate for Payer: BCN Medicare Advantage |
$9,368.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,368.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,368.23
|
| Rate for Payer: Mclaren Medicare |
$9,368.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,836.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,773.46
|
| Rate for Payer: PACE Medicare |
$8,899.82
|
| Rate for Payer: PACE SWMI |
$9,368.23
|
| Rate for Payer: PHP Commercial |
$10,305.05
|
| Rate for Payer: PHP Medicare Advantage |
$9,368.23
|
| Rate for Payer: Priority Health Medicare |
$9,368.23
|
| Rate for Payer: Railroad Medicare Medicare |
$9,368.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,368.23
|
| Rate for Payer: UHC Exchange |
$14,520.76
|
| Rate for Payer: UHC Medicare Advantage |
$9,368.23
|
| Rate for Payer: UHCCP DNSP |
$9,368.23
|
| Rate for Payer: VA VA |
$9,368.23
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS
|
Facility
|
IP
|
$98,811.46
|
|
|
Service Code
|
MSDRG 870
|
| Min. Negotiated Rate |
$60,561.86 |
| Max. Negotiated Rate |
$98,811.46 |
| Rate for Payer: Aetna Medicare |
$63,749.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79,686.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79,686.66
|
| Rate for Payer: BCBS MAPPO |
$63,749.33
|
| Rate for Payer: BCN Medicare Advantage |
$63,749.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63,749.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$63,749.33
|
| Rate for Payer: Mclaren Medicare |
$63,749.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66,936.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73,311.73
|
| Rate for Payer: PACE Medicare |
$60,561.86
|
| Rate for Payer: PACE SWMI |
$63,749.33
|
| Rate for Payer: PHP Commercial |
$70,124.26
|
| Rate for Payer: PHP Medicare Advantage |
$63,749.33
|
| Rate for Payer: Priority Health Medicare |
$63,749.33
|
| Rate for Payer: Railroad Medicare Medicare |
$63,749.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$63,749.33
|
| Rate for Payer: UHC Exchange |
$98,811.46
|
| Rate for Payer: UHC Medicare Advantage |
$63,749.33
|
| Rate for Payer: UHCCP DNSP |
$63,749.33
|
| Rate for Payer: VA VA |
$63,749.33
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC
|
Facility
|
IP
|
$29,734.70
|
|
|
Service Code
|
MSDRG 871
|
| Min. Negotiated Rate |
$18,224.50 |
| Max. Negotiated Rate |
$29,734.70 |
| Rate for Payer: Aetna Medicare |
$19,183.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,979.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,979.60
|
| Rate for Payer: BCBS MAPPO |
$19,183.68
|
| Rate for Payer: BCN Medicare Advantage |
$19,183.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,183.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,183.68
|
| Rate for Payer: Mclaren Medicare |
$19,183.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,142.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,061.23
|
| Rate for Payer: PACE Medicare |
$18,224.50
|
| Rate for Payer: PACE SWMI |
$19,183.68
|
| Rate for Payer: PHP Commercial |
$21,102.05
|
| Rate for Payer: PHP Medicare Advantage |
$19,183.68
|
| Rate for Payer: Priority Health Medicare |
$19,183.68
|
| Rate for Payer: Railroad Medicare Medicare |
$19,183.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,183.68
|
| Rate for Payer: UHC Exchange |
$29,734.70
|
| Rate for Payer: UHC Medicare Advantage |
$19,183.68
|
| Rate for Payer: UHCCP DNSP |
$19,183.68
|
| Rate for Payer: VA VA |
$19,183.68
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC
|
Facility
|
IP
|
$16,856.81
|
|
|
Service Code
|
MSDRG 872
|
| Min. Negotiated Rate |
$10,331.59 |
| Max. Negotiated Rate |
$16,856.81 |
| Rate for Payer: Aetna Medicare |
$10,875.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,594.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,594.20
|
| Rate for Payer: BCBS MAPPO |
$10,875.36
|
| Rate for Payer: BCN Medicare Advantage |
$10,875.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,875.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,875.36
|
| Rate for Payer: Mclaren Medicare |
$10,875.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,419.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,506.66
|
| Rate for Payer: PACE Medicare |
$10,331.59
|
| Rate for Payer: PACE SWMI |
$10,875.36
|
| Rate for Payer: PHP Commercial |
$11,962.90
|
| Rate for Payer: PHP Medicare Advantage |
$10,875.36
|
| Rate for Payer: Priority Health Medicare |
$10,875.36
|
| Rate for Payer: Railroad Medicare Medicare |
$10,875.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,875.36
|
| Rate for Payer: UHC Exchange |
$16,856.81
|
| Rate for Payer: UHC Medicare Advantage |
$10,875.36
|
| Rate for Payer: UHCCP DNSP |
$10,875.36
|
| Rate for Payer: VA VA |
$10,875.36
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
|
Facility
|
IP
|
$29,722.24
|
|
|
Service Code
|
MSDRG 511
|
| Min. Negotiated Rate |
$18,216.86 |
| Max. Negotiated Rate |
$29,722.24 |
| Rate for Payer: Aetna Medicare |
$19,175.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,969.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,969.55
|
| Rate for Payer: BCBS MAPPO |
$19,175.64
|
| Rate for Payer: BCN Medicare Advantage |
$19,175.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,175.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,175.64
|
| Rate for Payer: Mclaren Medicare |
$19,175.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,134.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,051.99
|
| Rate for Payer: PACE Medicare |
$18,216.86
|
| Rate for Payer: PACE SWMI |
$19,175.64
|
| Rate for Payer: PHP Commercial |
$21,093.20
|
| Rate for Payer: PHP Medicare Advantage |
$19,175.64
|
| Rate for Payer: Priority Health Medicare |
$19,175.64
|
| Rate for Payer: Railroad Medicare Medicare |
$19,175.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,175.64
|
| Rate for Payer: UHC Exchange |
$29,722.24
|
| Rate for Payer: UHC Medicare Advantage |
$19,175.64
|
| Rate for Payer: UHCCP DNSP |
$19,175.64
|
| Rate for Payer: VA VA |
$19,175.64
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC
|
Facility
|
IP
|
$42,127.12
|
|
|
Service Code
|
MSDRG 510
|
| Min. Negotiated Rate |
$25,819.85 |
| Max. Negotiated Rate |
$42,127.12 |
| Rate for Payer: Aetna Medicare |
$27,178.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,973.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,973.49
|
| Rate for Payer: BCBS MAPPO |
$27,178.79
|
| Rate for Payer: BCN Medicare Advantage |
$27,178.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,178.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$27,178.79
|
| Rate for Payer: Mclaren Medicare |
$27,178.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,537.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,255.61
|
| Rate for Payer: PACE Medicare |
$25,819.85
|
| Rate for Payer: PACE SWMI |
$27,178.79
|
| Rate for Payer: PHP Commercial |
$29,896.67
|
| Rate for Payer: PHP Medicare Advantage |
$27,178.79
|
| Rate for Payer: Priority Health Medicare |
$27,178.79
|
| Rate for Payer: Railroad Medicare Medicare |
$27,178.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,178.79
|
| Rate for Payer: UHC Exchange |
$42,127.12
|
| Rate for Payer: UHC Medicare Advantage |
$27,178.79
|
| Rate for Payer: UHCCP DNSP |
$27,178.79
|
| Rate for Payer: VA VA |
$27,178.79
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,834.43
|
|
|
Service Code
|
MSDRG 512
|
| Min. Negotiated Rate |
$15,221.10 |
| Max. Negotiated Rate |
$24,834.43 |
| Rate for Payer: Aetna Medicare |
$16,022.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,027.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,027.76
|
| Rate for Payer: BCBS MAPPO |
$16,022.21
|
| Rate for Payer: BCN Medicare Advantage |
$16,022.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,022.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,022.21
|
| Rate for Payer: Mclaren Medicare |
$16,022.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,823.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,425.54
|
| Rate for Payer: PACE Medicare |
$15,221.10
|
| Rate for Payer: PACE SWMI |
$16,022.21
|
| Rate for Payer: PHP Commercial |
$17,624.43
|
| Rate for Payer: PHP Medicare Advantage |
$16,022.21
|
| Rate for Payer: Priority Health Medicare |
$16,022.21
|
| Rate for Payer: Railroad Medicare Medicare |
$16,022.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,022.21
|
| Rate for Payer: UHC Exchange |
$24,834.43
|
| Rate for Payer: UHC Medicare Advantage |
$16,022.21
|
| Rate for Payer: UHCCP DNSP |
$16,022.21
|
| Rate for Payer: VA VA |
$16,022.21
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$21,221.81
|
|
|
Service Code
|
MSDRG 555
|
| Min. Negotiated Rate |
$13,006.92 |
| Max. Negotiated Rate |
$21,221.81 |
| Rate for Payer: Aetna Medicare |
$13,691.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,114.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,114.36
|
| Rate for Payer: BCBS MAPPO |
$13,691.49
|
| Rate for Payer: BCN Medicare Advantage |
$13,691.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,691.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,691.49
|
| Rate for Payer: Mclaren Medicare |
$13,691.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,376.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,745.21
|
| Rate for Payer: PACE Medicare |
$13,006.92
|
| Rate for Payer: PACE SWMI |
$13,691.49
|
| Rate for Payer: PHP Commercial |
$15,060.64
|
| Rate for Payer: PHP Medicare Advantage |
$13,691.49
|
| Rate for Payer: Priority Health Medicare |
$13,691.49
|
| Rate for Payer: Railroad Medicare Medicare |
$13,691.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,691.49
|
| Rate for Payer: UHC Exchange |
$21,221.81
|
| Rate for Payer: UHC Medicare Advantage |
$13,691.49
|
| Rate for Payer: UHCCP DNSP |
$13,691.49
|
| Rate for Payer: VA VA |
$13,691.49
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC
|
Facility
|
IP
|
$13,890.08
|
|
|
Service Code
|
MSDRG 556
|
| Min. Negotiated Rate |
$8,513.27 |
| Max. Negotiated Rate |
$13,890.08 |
| Rate for Payer: Aetna Medicare |
$8,961.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,201.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,201.67
|
| Rate for Payer: BCBS MAPPO |
$8,961.34
|
| Rate for Payer: BCN Medicare Advantage |
$8,961.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,961.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,961.34
|
| Rate for Payer: Mclaren Medicare |
$8,961.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,409.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,305.54
|
| Rate for Payer: PACE Medicare |
$8,513.27
|
| Rate for Payer: PACE SWMI |
$8,961.34
|
| Rate for Payer: PHP Commercial |
$9,857.47
|
| Rate for Payer: PHP Medicare Advantage |
$8,961.34
|
| Rate for Payer: Priority Health Medicare |
$8,961.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8,961.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,961.34
|
| Rate for Payer: UHC Exchange |
$13,890.08
|
| Rate for Payer: UHC Medicare Advantage |
$8,961.34
|
| Rate for Payer: UHCCP DNSP |
$8,961.34
|
| Rate for Payer: VA VA |
$8,961.34
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$20,386.42
|
|
|
Service Code
|
MSDRG 947
|
| Min. Negotiated Rate |
$12,494.90 |
| Max. Negotiated Rate |
$20,386.42 |
| Rate for Payer: Aetna Medicare |
$13,152.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,440.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,440.66
|
| Rate for Payer: BCBS MAPPO |
$13,152.53
|
| Rate for Payer: BCN Medicare Advantage |
$13,152.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,152.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,152.53
|
| Rate for Payer: Mclaren Medicare |
$13,152.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,810.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,125.41
|
| Rate for Payer: PACE Medicare |
$12,494.90
|
| Rate for Payer: PACE SWMI |
$13,152.53
|
| Rate for Payer: PHP Commercial |
$14,467.78
|
| Rate for Payer: PHP Medicare Advantage |
$13,152.53
|
| Rate for Payer: Priority Health Medicare |
$13,152.53
|
| Rate for Payer: Railroad Medicare Medicare |
$13,152.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,152.53
|
| Rate for Payer: UHC Exchange |
$20,386.42
|
| Rate for Payer: UHC Medicare Advantage |
$13,152.53
|
| Rate for Payer: UHCCP DNSP |
$13,152.53
|
| Rate for Payer: VA VA |
$13,152.53
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$13,585.81
|
|
|
Service Code
|
MSDRG 948
|
| Min. Negotiated Rate |
$8,326.79 |
| Max. Negotiated Rate |
$13,585.81 |
| Rate for Payer: Aetna Medicare |
$8,765.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,956.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,956.30
|
| Rate for Payer: BCBS MAPPO |
$8,765.04
|
| Rate for Payer: BCN Medicare Advantage |
$8,765.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,765.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,765.04
|
| Rate for Payer: Mclaren Medicare |
$8,765.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,203.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,079.80
|
| Rate for Payer: PACE Medicare |
$8,326.79
|
| Rate for Payer: PACE SWMI |
$8,765.04
|
| Rate for Payer: PHP Commercial |
$9,641.54
|
| Rate for Payer: PHP Medicare Advantage |
$8,765.04
|
| Rate for Payer: Priority Health Medicare |
$8,765.04
|
| Rate for Payer: Railroad Medicare Medicare |
$8,765.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,765.04
|
| Rate for Payer: UHC Exchange |
$13,585.81
|
| Rate for Payer: UHC Medicare Advantage |
$8,765.04
|
| Rate for Payer: UHCCP DNSP |
$8,765.04
|
| Rate for Payer: VA VA |
$8,765.04
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH CC
|
Facility
|
IP
|
$13,938.47
|
|
|
Service Code
|
MSDRG 194
|
| Min. Negotiated Rate |
$8,542.93 |
| Max. Negotiated Rate |
$13,938.47 |
| Rate for Payer: Aetna Medicare |
$8,992.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,240.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,240.70
|
| Rate for Payer: BCBS MAPPO |
$8,992.56
|
| Rate for Payer: BCN Medicare Advantage |
$8,992.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,992.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,992.56
|
| Rate for Payer: Mclaren Medicare |
$8,992.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,442.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,341.44
|
| Rate for Payer: PACE Medicare |
$8,542.93
|
| Rate for Payer: PACE SWMI |
$8,992.56
|
| Rate for Payer: PHP Commercial |
$9,891.82
|
| Rate for Payer: PHP Medicare Advantage |
$8,992.56
|
| Rate for Payer: Priority Health Medicare |
$8,992.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8,992.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,992.56
|
| Rate for Payer: UHC Exchange |
$13,938.47
|
| Rate for Payer: UHC Medicare Advantage |
$8,992.56
|
| Rate for Payer: UHCCP DNSP |
$8,992.56
|
| Rate for Payer: VA VA |
$8,992.56
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH MCC
|
Facility
|
IP
|
$20,822.10
|
|
|
Service Code
|
MSDRG 193
|
| Min. Negotiated Rate |
$12,761.93 |
| Max. Negotiated Rate |
$20,822.10 |
| Rate for Payer: Aetna Medicare |
$13,433.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,792.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,792.01
|
| Rate for Payer: BCBS MAPPO |
$13,433.61
|
| Rate for Payer: BCN Medicare Advantage |
$13,433.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,433.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,433.61
|
| Rate for Payer: Mclaren Medicare |
$13,433.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,105.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,448.65
|
| Rate for Payer: PACE Medicare |
$12,761.93
|
| Rate for Payer: PACE SWMI |
$13,433.61
|
| Rate for Payer: PHP Commercial |
$14,776.97
|
| Rate for Payer: PHP Medicare Advantage |
$13,433.61
|
| Rate for Payer: Priority Health Medicare |
$13,433.61
|
| Rate for Payer: Railroad Medicare Medicare |
$13,433.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,433.61
|
| Rate for Payer: UHC Exchange |
$20,822.10
|
| Rate for Payer: UHC Medicare Advantage |
$13,433.61
|
| Rate for Payer: UHCCP DNSP |
$13,433.61
|
| Rate for Payer: VA VA |
$13,433.61
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC
|
Facility
|
IP
|
$11,209.66
|
|
|
Service Code
|
MSDRG 195
|
| Min. Negotiated Rate |
$6,870.44 |
| Max. Negotiated Rate |
$11,209.66 |
| Rate for Payer: Aetna Medicare |
$7,232.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,040.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,040.05
|
| Rate for Payer: BCBS MAPPO |
$7,232.04
|
| Rate for Payer: BCN Medicare Advantage |
$7,232.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,232.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,232.04
|
| Rate for Payer: Mclaren Medicare |
$7,232.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,593.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,316.85
|
| Rate for Payer: PACE Medicare |
$6,870.44
|
| Rate for Payer: PACE SWMI |
$7,232.04
|
| Rate for Payer: PHP Commercial |
$7,955.24
|
| Rate for Payer: PHP Medicare Advantage |
$7,232.04
|
| Rate for Payer: Priority Health Medicare |
$7,232.04
|
| Rate for Payer: Railroad Medicare Medicare |
$7,232.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,232.04
|
| Rate for Payer: UHC Exchange |
$11,209.66
|
| Rate for Payer: UHC Medicare Advantage |
$7,232.04
|
| Rate for Payer: UHCCP DNSP |
$7,232.04
|
| Rate for Payer: VA VA |
$7,232.04
|
|
|
MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT
|
Facility
|
IP
|
$77,852.18
|
|
|
Service Code
|
MSDRG 008
|
| Min. Negotiated Rate |
$47,715.85 |
| Max. Negotiated Rate |
$77,852.18 |
| Rate for Payer: Aetna Medicare |
$50,227.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62,784.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62,784.01
|
| Rate for Payer: BCBS MAPPO |
$50,227.21
|
| Rate for Payer: BCN Medicare Advantage |
$50,227.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50,227.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$50,227.21
|
| Rate for Payer: Mclaren Medicare |
$50,227.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52,738.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57,761.29
|
| Rate for Payer: PACE Medicare |
$47,715.85
|
| Rate for Payer: PACE SWMI |
$50,227.21
|
| Rate for Payer: PHP Commercial |
$55,249.93
|
| Rate for Payer: PHP Medicare Advantage |
$50,227.21
|
| Rate for Payer: Priority Health Medicare |
$50,227.21
|
| Rate for Payer: Railroad Medicare Medicare |
$50,227.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$50,227.21
|
| Rate for Payer: UHC Exchange |
$77,852.18
|
| Rate for Payer: UHC Medicare Advantage |
$50,227.21
|
| Rate for Payer: UHCCP DNSP |
$50,227.21
|
| Rate for Payer: VA VA |
$50,227.21
|
|
|
MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS
|
Facility
|
IP
|
$112,238.43
|
|
|
Service Code
|
MSDRG 019
|
| Min. Negotiated Rate |
$68,791.30 |
| Max. Negotiated Rate |
$112,238.43 |
| Rate for Payer: Aetna Medicare |
$72,411.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90,514.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90,514.86
|
| Rate for Payer: BCBS MAPPO |
$72,411.89
|
| Rate for Payer: BCN Medicare Advantage |
$72,411.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72,411.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$72,411.89
|
| Rate for Payer: Mclaren Medicare |
$72,411.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76,032.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83,273.67
|
| Rate for Payer: PACE Medicare |
$68,791.30
|
| Rate for Payer: PACE SWMI |
$72,411.89
|
| Rate for Payer: PHP Commercial |
$79,653.08
|
| Rate for Payer: PHP Medicare Advantage |
$72,411.89
|
| Rate for Payer: Priority Health Medicare |
$72,411.89
|
| Rate for Payer: Railroad Medicare Medicare |
$72,411.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$72,411.89
|
| Rate for Payer: UHC Exchange |
$112,238.43
|
| Rate for Payer: UHC Medicare Advantage |
$72,411.89
|
| Rate for Payer: UHCCP DNSP |
$72,411.89
|
| Rate for Payer: VA VA |
$72,411.89
|
|
|
MS-DRG 42.00: SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL
|
Facility
|
IP
|
$56,706.22
|
|
|
Service Code
|
MSDRG 402
|
| Min. Negotiated Rate |
$34,755.43 |
| Max. Negotiated Rate |
$56,706.22 |
| Rate for Payer: Aetna Medicare |
$36,584.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,730.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,730.82
|
| Rate for Payer: BCBS MAPPO |
$36,584.66
|
| Rate for Payer: BCN Medicare Advantage |
$36,584.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,584.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$36,584.66
|
| Rate for Payer: Mclaren Medicare |
$36,584.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,413.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,072.36
|
| Rate for Payer: PACE Medicare |
$34,755.43
|
| Rate for Payer: PACE SWMI |
$36,584.66
|
| Rate for Payer: PHP Commercial |
$40,243.13
|
| Rate for Payer: PHP Medicare Advantage |
$36,584.66
|
| Rate for Payer: Priority Health Medicare |
$36,584.66
|
| Rate for Payer: Railroad Medicare Medicare |
$36,584.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$36,584.66
|
| Rate for Payer: UHC Exchange |
$56,706.22
|
| Rate for Payer: UHC Medicare Advantage |
$36,584.66
|
| Rate for Payer: UHCCP DNSP |
$36,584.66
|
| Rate for Payer: VA VA |
$36,584.66
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$73,827.43
|
|
|
Service Code
|
MSDRG 450
|
| Min. Negotiated Rate |
$45,249.07 |
| Max. Negotiated Rate |
$73,827.43 |
| Rate for Payer: Aetna Medicare |
$47,630.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59,538.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59,538.25
|
| Rate for Payer: BCBS MAPPO |
$47,630.60
|
| Rate for Payer: BCN Medicare Advantage |
$47,630.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47,630.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$47,630.60
|
| Rate for Payer: Mclaren Medicare |
$47,630.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50,012.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54,775.19
|
| Rate for Payer: PACE Medicare |
$45,249.07
|
| Rate for Payer: PACE SWMI |
$47,630.60
|
| Rate for Payer: PHP Commercial |
$52,393.66
|
| Rate for Payer: PHP Medicare Advantage |
$47,630.60
|
| Rate for Payer: Priority Health Medicare |
$47,630.60
|
| Rate for Payer: Railroad Medicare Medicare |
$47,630.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$47,630.60
|
| Rate for Payer: UHC Exchange |
$73,827.43
|
| Rate for Payer: UHC Medicare Advantage |
$47,630.60
|
| Rate for Payer: UHCCP DNSP |
$47,630.60
|
| Rate for Payer: VA VA |
$47,630.60
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$45,279.16
|
|
|
Service Code
|
MSDRG 451
|
| Min. Negotiated Rate |
$27,751.74 |
| Max. Negotiated Rate |
$45,279.16 |
| Rate for Payer: Aetna Medicare |
$29,212.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,515.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,515.45
|
| Rate for Payer: BCBS MAPPO |
$29,212.36
|
| Rate for Payer: BCN Medicare Advantage |
$29,212.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,212.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$29,212.36
|
| Rate for Payer: Mclaren Medicare |
$29,212.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,672.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,594.21
|
| Rate for Payer: PACE Medicare |
$27,751.74
|
| Rate for Payer: PACE SWMI |
$29,212.36
|
| Rate for Payer: PHP Commercial |
$32,133.60
|
| Rate for Payer: PHP Medicare Advantage |
$29,212.36
|
| Rate for Payer: Priority Health Medicare |
$29,212.36
|
| Rate for Payer: Railroad Medicare Medicare |
$29,212.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,212.36
|
| Rate for Payer: UHC Exchange |
$45,279.16
|
| Rate for Payer: UHC Medicare Advantage |
$29,212.36
|
| Rate for Payer: UHCCP DNSP |
$29,212.36
|
| Rate for Payer: VA VA |
$29,212.36
|
|
|
MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$35,944.75
|
|
|
Service Code
|
MSDRG 135
|
| Min. Negotiated Rate |
$22,030.65 |
| Max. Negotiated Rate |
$35,944.75 |
| Rate for Payer: Aetna Medicare |
$23,190.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,987.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,987.70
|
| Rate for Payer: BCBS MAPPO |
$23,190.16
|
| Rate for Payer: BCN Medicare Advantage |
$23,190.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,190.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$23,190.16
|
| Rate for Payer: Mclaren Medicare |
$23,190.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,349.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,668.68
|
| Rate for Payer: PACE Medicare |
$22,030.65
|
| Rate for Payer: PACE SWMI |
$23,190.16
|
| Rate for Payer: PHP Commercial |
$25,509.18
|
| Rate for Payer: PHP Medicare Advantage |
$23,190.16
|
| Rate for Payer: Priority Health Medicare |
$23,190.16
|
| Rate for Payer: Railroad Medicare Medicare |
$23,190.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,190.16
|
| Rate for Payer: UHC Exchange |
$35,944.75
|
| Rate for Payer: UHC Medicare Advantage |
$23,190.16
|
| Rate for Payer: UHCCP DNSP |
$23,190.16
|
| Rate for Payer: VA VA |
$23,190.16
|
|
|
MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,126.53
|
|
|
Service Code
|
MSDRG 136
|
| Min. Negotiated Rate |
$9,884.00 |
| Max. Negotiated Rate |
$16,126.53 |
| Rate for Payer: Aetna Medicare |
$10,404.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,005.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,005.26
|
| Rate for Payer: BCBS MAPPO |
$10,404.21
|
| Rate for Payer: BCN Medicare Advantage |
$10,404.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,404.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,404.21
|
| Rate for Payer: Mclaren Medicare |
$10,404.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,924.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,964.84
|
| Rate for Payer: PACE Medicare |
$9,884.00
|
| Rate for Payer: PACE SWMI |
$10,404.21
|
| Rate for Payer: PHP Commercial |
$11,444.63
|
| Rate for Payer: PHP Medicare Advantage |
$10,404.21
|
| Rate for Payer: Priority Health Medicare |
$10,404.21
|
| Rate for Payer: Railroad Medicare Medicare |
$10,404.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,404.21
|
| Rate for Payer: UHC Exchange |
$16,126.53
|
| Rate for Payer: UHC Medicare Advantage |
$10,404.21
|
| Rate for Payer: UHCCP DNSP |
$10,404.21
|
| Rate for Payer: VA VA |
$10,404.21
|
|
|
MS-DRG 42.00: SKIN DEBRIDEMENT WITH CC
|
Facility
|
IP
|
$25,754.20
|
|
|
Service Code
|
MSDRG 571
|
| Min. Negotiated Rate |
$15,784.83 |
| Max. Negotiated Rate |
$25,754.20 |
| Rate for Payer: Aetna Medicare |
$16,615.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,769.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,769.51
|
| Rate for Payer: BCBS MAPPO |
$16,615.61
|
| Rate for Payer: BCN Medicare Advantage |
$16,615.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,615.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,615.61
|
| Rate for Payer: Mclaren Medicare |
$16,615.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,446.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,107.95
|
| Rate for Payer: PACE Medicare |
$15,784.83
|
| Rate for Payer: PACE SWMI |
$16,615.61
|
| Rate for Payer: PHP Commercial |
$18,277.17
|
| Rate for Payer: PHP Medicare Advantage |
$16,615.61
|
| Rate for Payer: Priority Health Medicare |
$16,615.61
|
| Rate for Payer: Railroad Medicare Medicare |
$16,615.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,615.61
|
| Rate for Payer: UHC Exchange |
$25,754.20
|
| Rate for Payer: UHC Medicare Advantage |
$16,615.61
|
| Rate for Payer: UHCCP DNSP |
$16,615.61
|
| Rate for Payer: VA VA |
$16,615.61
|
|
