|
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 HMO/PPO/Tiered Network |
$18,499.29
|
| Rate for Payer: Priority Health Medicare |
$13,691.49
|
| Rate for Payer: Priority Health Narrow Network |
$14,799.44
|
| 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 |
$11,201.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,201.68
|
| 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 HMO/PPO/Tiered Network |
$11,217.73
|
| Rate for Payer: Priority Health Medicare |
$8,961.34
|
| Rate for Payer: Priority Health Narrow Network |
$8,974.18
|
| 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 HMO/PPO/Tiered Network |
$17,669.47
|
| Rate for Payer: Priority Health Medicare |
$13,152.53
|
| Rate for Payer: Priority Health Narrow Network |
$14,135.58
|
| 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 HMO/PPO/Tiered Network |
$10,915.48
|
| Rate for Payer: Priority Health Medicare |
$8,765.04
|
| Rate for Payer: Priority Health Narrow Network |
$8,732.38
|
| 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 HMO/PPO/Tiered Network |
$11,265.82
|
| Rate for Payer: Priority Health Medicare |
$8,992.56
|
| Rate for Payer: Priority Health Narrow Network |
$9,012.65
|
| 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 HMO/PPO/Tiered Network |
$18,104.99
|
| Rate for Payer: Priority Health Medicare |
$13,433.61
|
| Rate for Payer: Priority Health Narrow Network |
$14,483.99
|
| 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 |
$6,845.22 |
| 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 HMO/PPO/Tiered Network |
$8,556.52
|
| Rate for Payer: Priority Health Medicare |
$7,232.04
|
| Rate for Payer: Priority Health Narrow Network |
$6,845.22
|
| 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 HMO/PPO/Tiered Network |
$74,750.06
|
| Rate for Payer: Priority Health Medicare |
$50,227.21
|
| Rate for Payer: Priority Health Narrow Network |
$59,800.05
|
| 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 HMO/PPO/Tiered Network |
$108,903.35
|
| Rate for Payer: Priority Health Medicare |
$72,411.89
|
| Rate for Payer: Priority Health Narrow Network |
$87,122.68
|
| 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
|
$53,982.49
|
|
|
Service Code
|
MSDRG 402
|
| Min. Negotiated Rate |
$43,185.99 |
| Max. Negotiated Rate |
$53,982.49 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53,982.49
|
| Rate for Payer: Priority Health Narrow Network |
$43,185.99
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$70,750.70
|
|
|
Service Code
|
MSDRG 450
|
| Min. Negotiated Rate |
$56,600.56 |
| Max. Negotiated Rate |
$70,750.70 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70,750.70
|
| Rate for Payer: Priority Health Narrow Network |
$56,600.56
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$42,395.19
|
|
|
Service Code
|
MSDRG 451
|
| Min. Negotiated Rate |
$33,916.15 |
| Max. Negotiated Rate |
$42,395.19 |
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42,395.19
|
| Rate for Payer: Priority Health Narrow Network |
$33,916.15
|
|
|
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 HMO/PPO/Tiered Network |
$33,122.87
|
| Rate for Payer: Priority Health Medicare |
$23,190.16
|
| Rate for Payer: Priority Health Narrow Network |
$26,498.30
|
| 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 HMO/PPO/Tiered Network |
$13,439.29
|
| Rate for Payer: Priority Health Medicare |
$10,404.21
|
| Rate for Payer: Priority Health Narrow Network |
$10,751.44
|
| 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 HMO/PPO/Tiered Network |
$23,009.74
|
| Rate for Payer: Priority Health Medicare |
$16,615.61
|
| Rate for Payer: Priority Health Narrow Network |
$18,407.79
|
| 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
|
|
|
MS-DRG 42.00: SKIN DEBRIDEMENT WITH MCC
|
Facility
|
IP
|
$44,230.80
|
|
|
Service Code
|
MSDRG 570
|
| Min. Negotiated Rate |
$27,109.20 |
| Max. Negotiated Rate |
$44,230.80 |
| Rate for Payer: Aetna Medicare |
$28,536.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,670.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,670.00
|
| Rate for Payer: BCBS MAPPO |
$28,536.00
|
| Rate for Payer: BCN Medicare Advantage |
$28,536.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,536.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$28,536.00
|
| Rate for Payer: Mclaren Medicare |
$28,536.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,962.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,816.40
|
| Rate for Payer: PACE Medicare |
$27,109.20
|
| Rate for Payer: PACE SWMI |
$28,536.00
|
| Rate for Payer: PHP Commercial |
$31,389.60
|
| Rate for Payer: PHP Medicare Advantage |
$28,536.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41,359.28
|
| Rate for Payer: Priority Health Medicare |
$28,536.00
|
| Rate for Payer: Priority Health Narrow Network |
$33,087.43
|
| Rate for Payer: Railroad Medicare Medicare |
$28,536.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$28,536.00
|
| Rate for Payer: UHC Exchange |
$44,230.80
|
| Rate for Payer: UHC Medicare Advantage |
$28,536.00
|
| Rate for Payer: UHCCP DNSP |
$28,536.00
|
| Rate for Payer: VA VA |
$28,536.00
|
|
|
MS-DRG 42.00: SKIN DEBRIDEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$18,397.55
|
|
|
Service Code
|
MSDRG 572
|
| Min. Negotiated Rate |
$11,275.92 |
| Max. Negotiated Rate |
$18,397.55 |
| Rate for Payer: Aetna Medicare |
$11,869.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,836.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,836.74
|
| Rate for Payer: BCBS MAPPO |
$11,869.39
|
| Rate for Payer: BCN Medicare Advantage |
$11,869.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,869.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,869.39
|
| Rate for Payer: Mclaren Medicare |
$11,869.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,462.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,649.80
|
| Rate for Payer: PACE Medicare |
$11,275.92
|
| Rate for Payer: PACE SWMI |
$11,869.39
|
| Rate for Payer: PHP Commercial |
$13,056.33
|
| Rate for Payer: PHP Medicare Advantage |
$11,869.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,695.21
|
| Rate for Payer: Priority Health Medicare |
$11,869.39
|
| Rate for Payer: Priority Health Narrow Network |
$12,556.16
|
| Rate for Payer: Railroad Medicare Medicare |
$11,869.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,869.39
|
| Rate for Payer: UHC Exchange |
$18,397.55
|
| Rate for Payer: UHC Medicare Advantage |
$11,869.39
|
| Rate for Payer: UHCCP DNSP |
$11,869.39
|
| Rate for Payer: VA VA |
$11,869.39
|
|
|
MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$39,425.96
|
|
|
Service Code
|
MSDRG 577
|
| Min. Negotiated Rate |
$24,164.30 |
| Max. Negotiated Rate |
$39,425.96 |
| Rate for Payer: Aetna Medicare |
$25,436.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,795.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,795.12
|
| Rate for Payer: BCBS MAPPO |
$25,436.10
|
| Rate for Payer: BCN Medicare Advantage |
$25,436.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,436.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,436.10
|
| Rate for Payer: Mclaren Medicare |
$25,436.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,707.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,251.52
|
| Rate for Payer: PACE Medicare |
$24,164.30
|
| Rate for Payer: PACE SWMI |
$25,436.10
|
| Rate for Payer: PHP Commercial |
$27,979.71
|
| Rate for Payer: PHP Medicare Advantage |
$25,436.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36,580.93
|
| Rate for Payer: Priority Health Medicare |
$25,436.10
|
| Rate for Payer: Priority Health Narrow Network |
$29,264.74
|
| Rate for Payer: Railroad Medicare Medicare |
$25,436.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,436.10
|
| Rate for Payer: UHC Exchange |
$39,425.96
|
| Rate for Payer: UHC Medicare Advantage |
$25,436.10
|
| Rate for Payer: UHCCP DNSP |
$25,436.10
|
| Rate for Payer: VA VA |
$25,436.10
|
|
|
MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$77,218.74
|
|
|
Service Code
|
MSDRG 576
|
| Min. Negotiated Rate |
$47,327.61 |
| Max. Negotiated Rate |
$77,218.74 |
| Rate for Payer: Aetna Medicare |
$49,818.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62,273.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62,273.18
|
| Rate for Payer: BCBS MAPPO |
$49,818.54
|
| Rate for Payer: BCN Medicare Advantage |
$49,818.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,818.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$49,818.54
|
| Rate for Payer: Mclaren Medicare |
$49,818.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52,309.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57,291.32
|
| Rate for Payer: PACE Medicare |
$47,327.61
|
| Rate for Payer: PACE SWMI |
$49,818.54
|
| Rate for Payer: PHP Commercial |
$54,800.39
|
| Rate for Payer: PHP Medicare Advantage |
$49,818.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74,119.45
|
| Rate for Payer: Priority Health Medicare |
$49,818.54
|
| Rate for Payer: Priority Health Narrow Network |
$59,295.56
|
| Rate for Payer: Railroad Medicare Medicare |
$49,818.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$49,818.54
|
| Rate for Payer: UHC Exchange |
$77,218.74
|
| Rate for Payer: UHC Medicare Advantage |
$49,818.54
|
| Rate for Payer: UHCCP DNSP |
$49,818.54
|
| Rate for Payer: VA VA |
$49,818.54
|
|
|
MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$25,976.85
|
|
|
Service Code
|
MSDRG 578
|
| Min. Negotiated Rate |
$15,921.30 |
| Max. Negotiated Rate |
$25,976.85 |
| Rate for Payer: Aetna Medicare |
$16,759.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,949.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,949.08
|
| Rate for Payer: BCBS MAPPO |
$16,759.26
|
| Rate for Payer: BCN Medicare Advantage |
$16,759.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,759.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,759.26
|
| Rate for Payer: Mclaren Medicare |
$16,759.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,597.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,273.15
|
| Rate for Payer: PACE Medicare |
$15,921.30
|
| Rate for Payer: PACE SWMI |
$16,759.26
|
| Rate for Payer: PHP Commercial |
$18,435.19
|
| Rate for Payer: PHP Medicare Advantage |
$16,759.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,222.69
|
| Rate for Payer: Priority Health Medicare |
$16,759.26
|
| Rate for Payer: Priority Health Narrow Network |
$18,578.15
|
| Rate for Payer: Railroad Medicare Medicare |
$16,759.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,759.26
|
| Rate for Payer: UHC Exchange |
$25,976.85
|
| Rate for Payer: UHC Medicare Advantage |
$16,759.26
|
| Rate for Payer: UHCCP DNSP |
$16,759.26
|
| Rate for Payer: VA VA |
$16,759.26
|
|
|
MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$50,519.68
|
|
|
Service Code
|
MSDRG 574
|
| Min. Negotiated Rate |
$30,963.67 |
| Max. Negotiated Rate |
$50,519.68 |
| Rate for Payer: Aetna Medicare |
$32,593.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,741.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,741.68
|
| Rate for Payer: BCBS MAPPO |
$32,593.34
|
| Rate for Payer: BCN Medicare Advantage |
$32,593.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,593.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$32,593.34
|
| Rate for Payer: Mclaren Medicare |
$32,593.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34,223.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,482.34
|
| Rate for Payer: PACE Medicare |
$30,963.67
|
| Rate for Payer: PACE SWMI |
$32,593.34
|
| Rate for Payer: PHP Commercial |
$35,852.67
|
| Rate for Payer: PHP Medicare Advantage |
$32,593.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47,600.82
|
| Rate for Payer: Priority Health Medicare |
$32,593.34
|
| Rate for Payer: Priority Health Narrow Network |
$38,080.66
|
| Rate for Payer: Railroad Medicare Medicare |
$32,593.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,593.34
|
| Rate for Payer: UHC Exchange |
$50,519.68
|
| Rate for Payer: UHC Medicare Advantage |
$32,593.34
|
| Rate for Payer: UHCCP DNSP |
$32,593.34
|
| Rate for Payer: VA VA |
$32,593.34
|
|
|
MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$87,770.28
|
|
|
Service Code
|
MSDRG 573
|
| Min. Negotiated Rate |
$53,794.69 |
| Max. Negotiated Rate |
$87,770.28 |
| Rate for Payer: Aetna Medicare |
$56,625.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70,782.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70,782.49
|
| Rate for Payer: BCBS MAPPO |
$56,625.99
|
| Rate for Payer: BCN Medicare Advantage |
$56,625.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56,625.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$56,625.99
|
| Rate for Payer: Mclaren Medicare |
$56,625.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59,457.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65,119.89
|
| Rate for Payer: PACE Medicare |
$53,794.69
|
| Rate for Payer: PACE SWMI |
$56,625.99
|
| Rate for Payer: PHP Commercial |
$62,288.59
|
| Rate for Payer: PHP Medicare Advantage |
$56,625.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84,600.78
|
| Rate for Payer: Priority Health Medicare |
$56,625.99
|
| Rate for Payer: Priority Health Narrow Network |
$67,680.63
|
| Rate for Payer: Railroad Medicare Medicare |
$56,625.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$56,625.99
|
| Rate for Payer: UHC Exchange |
$87,770.28
|
| Rate for Payer: UHC Medicare Advantage |
$56,625.99
|
| Rate for Payer: UHCCP DNSP |
$56,625.99
|
| Rate for Payer: VA VA |
$56,625.99
|
|
|
MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,213.24
|
|
|
Service Code
|
MSDRG 575
|
| Min. Negotiated Rate |
$18,517.79 |
| Max. Negotiated Rate |
$30,213.24 |
| Rate for Payer: Aetna Medicare |
$19,492.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,365.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,365.51
|
| Rate for Payer: BCBS MAPPO |
$19,492.41
|
| Rate for Payer: BCN Medicare Advantage |
$19,492.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,492.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,492.41
|
| Rate for Payer: Mclaren Medicare |
$19,492.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,467.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,416.27
|
| Rate for Payer: PACE Medicare |
$18,517.79
|
| Rate for Payer: PACE SWMI |
$19,492.41
|
| Rate for Payer: PHP Commercial |
$21,441.65
|
| Rate for Payer: PHP Medicare Advantage |
$19,492.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27,429.51
|
| Rate for Payer: Priority Health Medicare |
$19,492.41
|
| Rate for Payer: Priority Health Narrow Network |
$21,943.61
|
| Rate for Payer: Railroad Medicare Medicare |
$19,492.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,492.41
|
| Rate for Payer: UHC Exchange |
$30,213.24
|
| Rate for Payer: UHC Medicare Advantage |
$19,492.41
|
| Rate for Payer: UHCCP DNSP |
$19,492.41
|
| Rate for Payer: VA VA |
$19,492.41
|
|
|
MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$29,052.83
|
|
|
Service Code
|
MSDRG 623
|
| Min. Negotiated Rate |
$17,806.57 |
| Max. Negotiated Rate |
$29,052.83 |
| Rate for Payer: Aetna Medicare |
$18,743.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,429.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,429.70
|
| Rate for Payer: BCBS MAPPO |
$18,743.76
|
| Rate for Payer: BCN Medicare Advantage |
$18,743.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,743.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,743.76
|
| Rate for Payer: Mclaren Medicare |
$18,743.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,680.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,555.32
|
| Rate for Payer: PACE Medicare |
$17,806.57
|
| Rate for Payer: PACE SWMI |
$18,743.76
|
| Rate for Payer: PHP Commercial |
$20,618.14
|
| Rate for Payer: PHP Medicare Advantage |
$18,743.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,296.06
|
| Rate for Payer: Priority Health Medicare |
$18,743.76
|
| Rate for Payer: Priority Health Narrow Network |
$21,036.85
|
| Rate for Payer: Railroad Medicare Medicare |
$18,743.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,743.76
|
| Rate for Payer: UHC Exchange |
$29,052.83
|
| Rate for Payer: UHC Medicare Advantage |
$18,743.76
|
| Rate for Payer: UHCCP DNSP |
$18,743.76
|
| Rate for Payer: VA VA |
$18,743.76
|
|
|
MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$54,352.21
|
|
|
Service Code
|
MSDRG 622
|
| Min. Negotiated Rate |
$33,312.64 |
| Max. Negotiated Rate |
$54,352.21 |
| Rate for Payer: Aetna Medicare |
$35,065.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43,832.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43,832.42
|
| Rate for Payer: BCBS MAPPO |
$35,065.94
|
| Rate for Payer: BCN Medicare Advantage |
$35,065.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,065.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$35,065.94
|
| Rate for Payer: Mclaren Medicare |
$35,065.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36,819.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40,325.83
|
| Rate for Payer: PACE Medicare |
$33,312.64
|
| Rate for Payer: PACE SWMI |
$35,065.94
|
| Rate for Payer: PHP Commercial |
$38,572.53
|
| Rate for Payer: PHP Medicare Advantage |
$35,065.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51,438.07
|
| Rate for Payer: Priority Health Medicare |
$35,065.94
|
| Rate for Payer: Priority Health Narrow Network |
$41,150.45
|
| Rate for Payer: Railroad Medicare Medicare |
$35,065.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$35,065.94
|
| Rate for Payer: UHC Exchange |
$54,352.21
|
| Rate for Payer: UHC Medicare Advantage |
$35,065.94
|
| Rate for Payer: UHCCP DNSP |
$35,065.94
|
| Rate for Payer: VA VA |
$35,065.94
|
|
