|
MS-DRG 42.00: SPINAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$86,681.80
|
|
|
Service Code
|
MSDRG 028
|
| Min. Negotiated Rate |
$53,127.55 |
| Max. Negotiated Rate |
$86,681.80 |
| Rate for Payer: Aetna Medicare |
$55,923.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69,904.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69,904.68
|
| Rate for Payer: BCBS MAPPO |
$55,923.74
|
| Rate for Payer: BCN Medicare Advantage |
$55,923.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55,923.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$55,923.74
|
| Rate for Payer: Mclaren Medicare |
$55,923.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58,719.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64,312.30
|
| Rate for Payer: PACE Medicare |
$53,127.55
|
| Rate for Payer: PACE SWMI |
$55,923.74
|
| Rate for Payer: PHP Commercial |
$61,516.11
|
| Rate for Payer: PHP Medicare Advantage |
$55,923.74
|
| Rate for Payer: Priority Health Medicare |
$55,923.74
|
| Rate for Payer: Railroad Medicare Medicare |
$55,923.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$55,923.74
|
| Rate for Payer: UHC Exchange |
$86,681.80
|
| Rate for Payer: UHC Medicare Advantage |
$55,923.74
|
| Rate for Payer: UHCCP DNSP |
$55,923.74
|
| Rate for Payer: VA VA |
$55,923.74
|
|
|
MS-DRG 42.00: SPINAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$33,376.37
|
|
|
Service Code
|
MSDRG 030
|
| Min. Negotiated Rate |
$20,456.48 |
| Max. Negotiated Rate |
$33,376.37 |
| Rate for Payer: Aetna Medicare |
$21,533.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,916.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,916.42
|
| Rate for Payer: BCBS MAPPO |
$21,533.14
|
| Rate for Payer: BCN Medicare Advantage |
$21,533.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,533.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,533.14
|
| Rate for Payer: Mclaren Medicare |
$21,533.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,609.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,763.11
|
| Rate for Payer: PACE Medicare |
$20,456.48
|
| Rate for Payer: PACE SWMI |
$21,533.14
|
| Rate for Payer: PHP Commercial |
$23,686.45
|
| Rate for Payer: PHP Medicare Advantage |
$21,533.14
|
| Rate for Payer: Priority Health Medicare |
$21,533.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21,533.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,533.14
|
| Rate for Payer: UHC Exchange |
$33,376.37
|
| Rate for Payer: UHC Medicare Advantage |
$21,533.14
|
| Rate for Payer: UHCCP DNSP |
$21,533.14
|
| Rate for Payer: VA VA |
$21,533.14
|
|
|
MS-DRG 42.00: SPLENIC PROCEDURES WITH CC
|
Facility
|
IP
|
$42,897.51
|
|
|
Service Code
|
MSDRG 800
|
| Min. Negotiated Rate |
$26,292.02 |
| Max. Negotiated Rate |
$42,897.51 |
| Rate for Payer: Aetna Medicare |
$27,675.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,594.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,594.76
|
| Rate for Payer: BCBS MAPPO |
$27,675.81
|
| Rate for Payer: BCN Medicare Advantage |
$27,675.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,675.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$27,675.81
|
| Rate for Payer: Mclaren Medicare |
$27,675.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,059.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,827.18
|
| Rate for Payer: PACE Medicare |
$26,292.02
|
| Rate for Payer: PACE SWMI |
$27,675.81
|
| Rate for Payer: PHP Commercial |
$30,443.39
|
| Rate for Payer: PHP Medicare Advantage |
$27,675.81
|
| Rate for Payer: Priority Health Medicare |
$27,675.81
|
| Rate for Payer: Railroad Medicare Medicare |
$27,675.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,675.81
|
| Rate for Payer: UHC Exchange |
$42,897.51
|
| Rate for Payer: UHC Medicare Advantage |
$27,675.81
|
| Rate for Payer: UHCCP DNSP |
$27,675.81
|
| Rate for Payer: VA VA |
$27,675.81
|
|
|
MS-DRG 42.00: SPLENIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$68,360.10
|
|
|
Service Code
|
MSDRG 799
|
| Min. Negotiated Rate |
$41,898.13 |
| Max. Negotiated Rate |
$68,360.10 |
| Rate for Payer: Aetna Medicare |
$44,103.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55,129.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55,129.11
|
| Rate for Payer: BCBS MAPPO |
$44,103.29
|
| Rate for Payer: BCN Medicare Advantage |
$44,103.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44,103.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$44,103.29
|
| Rate for Payer: Mclaren Medicare |
$44,103.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46,308.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50,718.78
|
| Rate for Payer: PACE Medicare |
$41,898.13
|
| Rate for Payer: PACE SWMI |
$44,103.29
|
| Rate for Payer: PHP Commercial |
$48,513.62
|
| Rate for Payer: PHP Medicare Advantage |
$44,103.29
|
| Rate for Payer: Priority Health Medicare |
$44,103.29
|
| Rate for Payer: Railroad Medicare Medicare |
$44,103.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$44,103.29
|
| Rate for Payer: UHC Exchange |
$68,360.10
|
| Rate for Payer: UHC Medicare Advantage |
$44,103.29
|
| Rate for Payer: UHCCP DNSP |
$44,103.29
|
| Rate for Payer: VA VA |
$44,103.29
|
|
|
MS-DRG 42.00: SPLENIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$25,303.28
|
|
|
Service Code
|
MSDRG 801
|
| Min. Negotiated Rate |
$15,508.47 |
| Max. Negotiated Rate |
$25,303.28 |
| Rate for Payer: Aetna Medicare |
$16,324.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,405.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,405.88
|
| Rate for Payer: BCBS MAPPO |
$16,324.70
|
| Rate for Payer: BCN Medicare Advantage |
$16,324.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,324.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,324.70
|
| Rate for Payer: Mclaren Medicare |
$16,324.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,140.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,773.40
|
| Rate for Payer: PACE Medicare |
$15,508.47
|
| Rate for Payer: PACE SWMI |
$16,324.70
|
| Rate for Payer: PHP Commercial |
$17,957.17
|
| Rate for Payer: PHP Medicare Advantage |
$16,324.70
|
| Rate for Payer: Priority Health Medicare |
$16,324.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16,324.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,324.70
|
| Rate for Payer: UHC Exchange |
$25,303.28
|
| Rate for Payer: UHC Medicare Advantage |
$16,324.70
|
| Rate for Payer: UHCCP DNSP |
$16,324.70
|
| Rate for Payer: VA VA |
$16,324.70
|
|
|
MS-DRG 42.00: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC
|
Facility
|
IP
|
$15,307.77
|
|
|
Service Code
|
MSDRG 537
|
| Min. Negotiated Rate |
$9,382.18 |
| Max. Negotiated Rate |
$15,307.77 |
| Rate for Payer: Aetna Medicare |
$9,875.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,344.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,344.98
|
| Rate for Payer: BCBS MAPPO |
$9,875.98
|
| Rate for Payer: BCN Medicare Advantage |
$9,875.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,875.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,875.98
|
| Rate for Payer: Mclaren Medicare |
$9,875.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,369.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,357.38
|
| Rate for Payer: PACE Medicare |
$9,382.18
|
| Rate for Payer: PACE SWMI |
$9,875.98
|
| Rate for Payer: PHP Commercial |
$10,863.58
|
| Rate for Payer: PHP Medicare Advantage |
$9,875.98
|
| Rate for Payer: Priority Health Medicare |
$9,875.98
|
| Rate for Payer: Railroad Medicare Medicare |
$9,875.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,875.98
|
| Rate for Payer: UHC Exchange |
$15,307.77
|
| Rate for Payer: UHC Medicare Advantage |
$9,875.98
|
| Rate for Payer: UHCCP DNSP |
$9,875.98
|
| Rate for Payer: VA VA |
$9,875.98
|
|
|
MS-DRG 42.00: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC
|
Facility
|
IP
|
$11,884.61
|
|
|
Service Code
|
MSDRG 538
|
| Min. Negotiated Rate |
$7,284.12 |
| Max. Negotiated Rate |
$11,884.61 |
| Rate for Payer: Aetna Medicare |
$7,667.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,584.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,584.36
|
| Rate for Payer: BCBS MAPPO |
$7,667.49
|
| Rate for Payer: BCN Medicare Advantage |
$7,667.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,667.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,667.49
|
| Rate for Payer: Mclaren Medicare |
$7,667.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,050.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,817.61
|
| Rate for Payer: PACE Medicare |
$7,284.12
|
| Rate for Payer: PACE SWMI |
$7,667.49
|
| Rate for Payer: PHP Commercial |
$8,434.24
|
| Rate for Payer: PHP Medicare Advantage |
$7,667.49
|
| Rate for Payer: Priority Health Medicare |
$7,667.49
|
| Rate for Payer: Railroad Medicare Medicare |
$7,667.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,667.49
|
| Rate for Payer: UHC Exchange |
$11,884.61
|
| Rate for Payer: UHC Medicare Advantage |
$7,667.49
|
| Rate for Payer: UHCCP DNSP |
$7,667.49
|
| Rate for Payer: VA VA |
$7,667.49
|
|
|
MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC
|
Facility
|
IP
|
$36,179.87
|
|
|
Service Code
|
MSDRG 327
|
| Min. Negotiated Rate |
$22,174.76 |
| Max. Negotiated Rate |
$36,179.87 |
| Rate for Payer: Aetna Medicare |
$23,341.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,177.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,177.31
|
| Rate for Payer: BCBS MAPPO |
$23,341.85
|
| Rate for Payer: BCN Medicare Advantage |
$23,341.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,341.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$23,341.85
|
| Rate for Payer: Mclaren Medicare |
$23,341.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,508.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,843.13
|
| Rate for Payer: PACE Medicare |
$22,174.76
|
| Rate for Payer: PACE SWMI |
$23,341.85
|
| Rate for Payer: PHP Commercial |
$25,676.03
|
| Rate for Payer: PHP Medicare Advantage |
$23,341.85
|
| Rate for Payer: Priority Health Medicare |
$23,341.85
|
| Rate for Payer: Railroad Medicare Medicare |
$23,341.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,341.85
|
| Rate for Payer: UHC Exchange |
$36,179.87
|
| Rate for Payer: UHC Medicare Advantage |
$23,341.85
|
| Rate for Payer: UHCCP DNSP |
$23,341.85
|
| Rate for Payer: VA VA |
$23,341.85
|
|
|
MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$72,844.03
|
|
|
Service Code
|
MSDRG 326
|
| Min. Negotiated Rate |
$44,646.34 |
| Max. Negotiated Rate |
$72,844.03 |
| Rate for Payer: Aetna Medicare |
$46,996.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58,745.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58,745.19
|
| Rate for Payer: BCBS MAPPO |
$46,996.15
|
| Rate for Payer: BCN Medicare Advantage |
$46,996.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,996.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$46,996.15
|
| Rate for Payer: Mclaren Medicare |
$46,996.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49,345.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54,045.57
|
| Rate for Payer: PACE Medicare |
$44,646.34
|
| Rate for Payer: PACE SWMI |
$46,996.15
|
| Rate for Payer: PHP Commercial |
$51,695.76
|
| Rate for Payer: PHP Medicare Advantage |
$46,996.15
|
| Rate for Payer: Priority Health Medicare |
$46,996.15
|
| Rate for Payer: Railroad Medicare Medicare |
$46,996.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$46,996.15
|
| Rate for Payer: UHC Exchange |
$72,844.03
|
| Rate for Payer: UHC Medicare Advantage |
$46,996.15
|
| Rate for Payer: UHCCP DNSP |
$46,996.15
|
| Rate for Payer: VA VA |
$46,996.15
|
|
|
MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,636.63
|
|
|
Service Code
|
MSDRG 328
|
| Min. Negotiated Rate |
$15,099.87 |
| Max. Negotiated Rate |
$24,636.63 |
| Rate for Payer: Aetna Medicare |
$15,894.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,868.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,868.25
|
| Rate for Payer: BCBS MAPPO |
$15,894.60
|
| Rate for Payer: BCN Medicare Advantage |
$15,894.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,894.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,894.60
|
| Rate for Payer: Mclaren Medicare |
$15,894.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,689.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,278.79
|
| Rate for Payer: PACE Medicare |
$15,099.87
|
| Rate for Payer: PACE SWMI |
$15,894.60
|
| Rate for Payer: PHP Commercial |
$17,484.06
|
| Rate for Payer: PHP Medicare Advantage |
$15,894.60
|
| Rate for Payer: Priority Health Medicare |
$15,894.60
|
| Rate for Payer: Railroad Medicare Medicare |
$15,894.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,894.60
|
| Rate for Payer: UHC Exchange |
$24,636.63
|
| Rate for Payer: UHC Medicare Advantage |
$15,894.60
|
| Rate for Payer: UHCCP DNSP |
$15,894.60
|
| Rate for Payer: VA VA |
$15,894.60
|
|
|
MS-DRG 42.00: SYNCOPE AND COLLAPSE
|
Facility
|
IP
|
$14,648.01
|
|
|
Service Code
|
MSDRG 312
|
| Min. Negotiated Rate |
$8,977.81 |
| Max. Negotiated Rate |
$14,648.01 |
| Rate for Payer: Aetna Medicare |
$9,450.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,812.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,812.91
|
| Rate for Payer: BCBS MAPPO |
$9,450.33
|
| Rate for Payer: BCN Medicare Advantage |
$9,450.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,450.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,450.33
|
| Rate for Payer: Mclaren Medicare |
$9,450.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,922.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,867.88
|
| Rate for Payer: PACE Medicare |
$8,977.81
|
| Rate for Payer: PACE SWMI |
$9,450.33
|
| Rate for Payer: PHP Commercial |
$10,395.36
|
| Rate for Payer: PHP Medicare Advantage |
$9,450.33
|
| Rate for Payer: Priority Health Medicare |
$9,450.33
|
| Rate for Payer: Railroad Medicare Medicare |
$9,450.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,450.33
|
| Rate for Payer: UHC Exchange |
$14,648.01
|
| Rate for Payer: UHC Medicare Advantage |
$9,450.33
|
| Rate for Payer: UHCCP DNSP |
$9,450.33
|
| Rate for Payer: VA VA |
$9,450.33
|
|
|
MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITH MCC
|
Facility
|
IP
|
$24,030.83
|
|
|
Service Code
|
MSDRG 557
|
| Min. Negotiated Rate |
$14,728.57 |
| Max. Negotiated Rate |
$24,030.83 |
| Rate for Payer: Aetna Medicare |
$15,503.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,379.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,379.70
|
| Rate for Payer: BCBS MAPPO |
$15,503.76
|
| Rate for Payer: BCN Medicare Advantage |
$15,503.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,503.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,503.76
|
| Rate for Payer: Mclaren Medicare |
$15,503.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,278.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,829.32
|
| Rate for Payer: PACE Medicare |
$14,728.57
|
| Rate for Payer: PACE SWMI |
$15,503.76
|
| Rate for Payer: PHP Commercial |
$17,054.14
|
| Rate for Payer: PHP Medicare Advantage |
$15,503.76
|
| Rate for Payer: Priority Health Medicare |
$15,503.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15,503.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,503.76
|
| Rate for Payer: UHC Exchange |
$24,030.83
|
| Rate for Payer: UHC Medicare Advantage |
$15,503.76
|
| Rate for Payer: UHCCP DNSP |
$15,503.76
|
| Rate for Payer: VA VA |
$15,503.76
|
|
|
MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC
|
Facility
|
IP
|
$14,544.27
|
|
|
Service Code
|
MSDRG 558
|
| Min. Negotiated Rate |
$8,914.23 |
| Max. Negotiated Rate |
$14,544.27 |
| Rate for Payer: Aetna Medicare |
$9,383.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,729.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,729.25
|
| Rate for Payer: BCBS MAPPO |
$9,383.40
|
| Rate for Payer: BCN Medicare Advantage |
$9,383.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,383.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,383.40
|
| Rate for Payer: Mclaren Medicare |
$9,383.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,852.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,790.91
|
| Rate for Payer: PACE Medicare |
$8,914.23
|
| Rate for Payer: PACE SWMI |
$9,383.40
|
| Rate for Payer: PHP Commercial |
$10,321.74
|
| Rate for Payer: PHP Medicare Advantage |
$9,383.40
|
| Rate for Payer: Priority Health Medicare |
$9,383.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9,383.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,383.40
|
| Rate for Payer: UHC Exchange |
$14,544.27
|
| Rate for Payer: UHC Medicare Advantage |
$9,383.40
|
| Rate for Payer: UHCCP DNSP |
$9,383.40
|
| Rate for Payer: VA VA |
$9,383.40
|
|
|
MS-DRG 42.00: TESTES PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$29,022.40
|
|
|
Service Code
|
MSDRG 711
|
| Min. Negotiated Rate |
$17,787.92 |
| Max. Negotiated Rate |
$29,022.40 |
| Rate for Payer: Aetna Medicare |
$18,724.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,405.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,405.16
|
| Rate for Payer: BCBS MAPPO |
$18,724.13
|
| Rate for Payer: BCN Medicare Advantage |
$18,724.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,724.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,724.13
|
| Rate for Payer: Mclaren Medicare |
$18,724.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,660.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,532.75
|
| Rate for Payer: PACE Medicare |
$17,787.92
|
| Rate for Payer: PACE SWMI |
$18,724.13
|
| Rate for Payer: PHP Commercial |
$20,596.54
|
| Rate for Payer: PHP Medicare Advantage |
$18,724.13
|
| Rate for Payer: Priority Health Medicare |
$18,724.13
|
| Rate for Payer: Railroad Medicare Medicare |
$18,724.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,724.13
|
| Rate for Payer: UHC Exchange |
$29,022.40
|
| Rate for Payer: UHC Medicare Advantage |
$18,724.13
|
| Rate for Payer: UHCCP DNSP |
$18,724.13
|
| Rate for Payer: VA VA |
$18,724.13
|
|
|
MS-DRG 42.00: TESTES PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$17,390.67
|
|
|
Service Code
|
MSDRG 712
|
| Min. Negotiated Rate |
$10,658.80 |
| Max. Negotiated Rate |
$17,390.67 |
| Rate for Payer: Aetna Medicare |
$11,219.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,024.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,024.74
|
| Rate for Payer: BCBS MAPPO |
$11,219.79
|
| Rate for Payer: BCN Medicare Advantage |
$11,219.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,219.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,219.79
|
| Rate for Payer: Mclaren Medicare |
$11,219.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,780.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,902.76
|
| Rate for Payer: PACE Medicare |
$10,658.80
|
| Rate for Payer: PACE SWMI |
$11,219.79
|
| Rate for Payer: PHP Commercial |
$12,341.77
|
| Rate for Payer: PHP Medicare Advantage |
$11,219.79
|
| Rate for Payer: Priority Health Medicare |
$11,219.79
|
| Rate for Payer: Railroad Medicare Medicare |
$11,219.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,219.79
|
| Rate for Payer: UHC Exchange |
$17,390.67
|
| Rate for Payer: UHC Medicare Advantage |
$11,219.79
|
| Rate for Payer: UHCCP DNSP |
$11,219.79
|
| Rate for Payer: VA VA |
$11,219.79
|
|
|
MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC
|
Facility
|
IP
|
$23,472.08
|
|
|
Service Code
|
MSDRG 626
|
| Min. Negotiated Rate |
$14,386.12 |
| Max. Negotiated Rate |
$23,472.08 |
| Rate for Payer: Aetna Medicare |
$15,143.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,929.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,929.10
|
| Rate for Payer: BCBS MAPPO |
$15,143.28
|
| Rate for Payer: BCN Medicare Advantage |
$15,143.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,143.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,143.28
|
| Rate for Payer: Mclaren Medicare |
$15,143.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,900.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,414.77
|
| Rate for Payer: PACE Medicare |
$14,386.12
|
| Rate for Payer: PACE SWMI |
$15,143.28
|
| Rate for Payer: PHP Commercial |
$16,657.61
|
| Rate for Payer: PHP Medicare Advantage |
$15,143.28
|
| Rate for Payer: Priority Health Medicare |
$15,143.28
|
| Rate for Payer: Railroad Medicare Medicare |
$15,143.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,143.28
|
| Rate for Payer: UHC Exchange |
$23,472.08
|
| Rate for Payer: UHC Medicare Advantage |
$15,143.28
|
| Rate for Payer: UHCCP DNSP |
$15,143.28
|
| Rate for Payer: VA VA |
$15,143.28
|
|
|
MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$42,251.61
|
|
|
Service Code
|
MSDRG 625
|
| Min. Negotiated Rate |
$25,896.15 |
| Max. Negotiated Rate |
$42,251.61 |
| Rate for Payer: Aetna Medicare |
$27,259.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,073.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,073.88
|
| Rate for Payer: BCBS MAPPO |
$27,259.10
|
| Rate for Payer: BCN Medicare Advantage |
$27,259.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,259.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$27,259.10
|
| Rate for Payer: Mclaren Medicare |
$27,259.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,622.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,347.97
|
| Rate for Payer: PACE Medicare |
$25,896.15
|
| Rate for Payer: PACE SWMI |
$27,259.10
|
| Rate for Payer: PHP Commercial |
$29,985.01
|
| Rate for Payer: PHP Medicare Advantage |
$27,259.10
|
| Rate for Payer: Priority Health Medicare |
$27,259.10
|
| Rate for Payer: Railroad Medicare Medicare |
$27,259.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,259.10
|
| Rate for Payer: UHC Exchange |
$42,251.61
|
| Rate for Payer: UHC Medicare Advantage |
$27,259.10
|
| Rate for Payer: UHCCP DNSP |
$27,259.10
|
| Rate for Payer: VA VA |
$27,259.10
|
|
|
MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,119.51
|
|
|
Service Code
|
MSDRG 627
|
| Min. Negotiated Rate |
$12,331.31 |
| Max. Negotiated Rate |
$20,119.51 |
| Rate for Payer: Aetna Medicare |
$12,980.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,225.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,225.41
|
| Rate for Payer: BCBS MAPPO |
$12,980.33
|
| Rate for Payer: BCN Medicare Advantage |
$12,980.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,980.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,980.33
|
| Rate for Payer: Mclaren Medicare |
$12,980.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,629.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,927.38
|
| Rate for Payer: PACE Medicare |
$12,331.31
|
| Rate for Payer: PACE SWMI |
$12,980.33
|
| Rate for Payer: PHP Commercial |
$14,278.36
|
| Rate for Payer: PHP Medicare Advantage |
$12,980.33
|
| Rate for Payer: Priority Health Medicare |
$12,980.33
|
| Rate for Payer: Railroad Medicare Medicare |
$12,980.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,980.33
|
| Rate for Payer: UHC Exchange |
$20,119.51
|
| Rate for Payer: UHC Medicare Advantage |
$12,980.33
|
| Rate for Payer: UHCCP DNSP |
$12,980.33
|
| Rate for Payer: VA VA |
$12,980.33
|
|
|
MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC
|
Facility
|
IP
|
$59,354.83
|
|
|
Service Code
|
MSDRG 012
|
| Min. Negotiated Rate |
$36,378.77 |
| Max. Negotiated Rate |
$59,354.83 |
| Rate for Payer: Aetna Medicare |
$38,293.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47,866.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47,866.80
|
| Rate for Payer: BCBS MAPPO |
$38,293.44
|
| Rate for Payer: BCN Medicare Advantage |
$38,293.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38,293.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$38,293.44
|
| Rate for Payer: Mclaren Medicare |
$38,293.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40,208.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44,037.46
|
| Rate for Payer: PACE Medicare |
$36,378.77
|
| Rate for Payer: PACE SWMI |
$38,293.44
|
| Rate for Payer: PHP Commercial |
$42,122.78
|
| Rate for Payer: PHP Medicare Advantage |
$38,293.44
|
| Rate for Payer: Priority Health Medicare |
$38,293.44
|
| Rate for Payer: Railroad Medicare Medicare |
$38,293.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$38,293.44
|
| Rate for Payer: UHC Exchange |
$59,354.83
|
| Rate for Payer: UHC Medicare Advantage |
$38,293.44
|
| Rate for Payer: UHCCP DNSP |
$38,293.44
|
| Rate for Payer: VA VA |
$38,293.44
|
|
|
MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC
|
Facility
|
IP
|
$77,227.03
|
|
|
Service Code
|
MSDRG 011
|
| Min. Negotiated Rate |
$47,332.70 |
| Max. Negotiated Rate |
$77,227.03 |
| Rate for Payer: Aetna Medicare |
$49,823.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62,279.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62,279.86
|
| Rate for Payer: BCBS MAPPO |
$49,823.89
|
| Rate for Payer: BCN Medicare Advantage |
$49,823.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,823.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$49,823.89
|
| Rate for Payer: Mclaren Medicare |
$49,823.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52,315.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57,297.47
|
| Rate for Payer: PACE Medicare |
$47,332.70
|
| Rate for Payer: PACE SWMI |
$49,823.89
|
| Rate for Payer: PHP Commercial |
$54,806.28
|
| Rate for Payer: PHP Medicare Advantage |
$49,823.89
|
| Rate for Payer: Priority Health Medicare |
$49,823.89
|
| Rate for Payer: Railroad Medicare Medicare |
$49,823.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$49,823.89
|
| Rate for Payer: UHC Exchange |
$77,227.03
|
| Rate for Payer: UHC Medicare Advantage |
$49,823.89
|
| Rate for Payer: UHCCP DNSP |
$49,823.89
|
| Rate for Payer: VA VA |
$49,823.89
|
|
|
MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$39,248.93
|
|
|
Service Code
|
MSDRG 013
|
| Min. Negotiated Rate |
$24,055.80 |
| Max. Negotiated Rate |
$39,248.93 |
| Rate for Payer: Aetna Medicare |
$25,321.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,652.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,652.36
|
| Rate for Payer: BCBS MAPPO |
$25,321.89
|
| Rate for Payer: BCN Medicare Advantage |
$25,321.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,321.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,321.89
|
| Rate for Payer: Mclaren Medicare |
$25,321.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,587.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,120.17
|
| Rate for Payer: PACE Medicare |
$24,055.80
|
| Rate for Payer: PACE SWMI |
$25,321.89
|
| Rate for Payer: PHP Commercial |
$27,854.08
|
| Rate for Payer: PHP Medicare Advantage |
$25,321.89
|
| Rate for Payer: Priority Health Medicare |
$25,321.89
|
| Rate for Payer: Railroad Medicare Medicare |
$25,321.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,321.89
|
| Rate for Payer: UHC Exchange |
$39,248.93
|
| Rate for Payer: UHC Medicare Advantage |
$25,321.89
|
| Rate for Payer: UHCCP DNSP |
$25,321.89
|
| Rate for Payer: VA VA |
$25,321.89
|
|
|
MS-DRG 42.00: TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES
|
Facility
|
IP
|
$198,026.98
|
|
|
Service Code
|
MSDRG 004
|
| Min. Negotiated Rate |
$121,371.37 |
| Max. Negotiated Rate |
$198,026.98 |
| Rate for Payer: Aetna Medicare |
$127,759.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159,699.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159,699.17
|
| Rate for Payer: BCBS MAPPO |
$127,759.34
|
| Rate for Payer: BCN Medicare Advantage |
$127,759.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127,759.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$127,759.34
|
| Rate for Payer: Mclaren Medicare |
$127,759.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134,147.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146,923.24
|
| Rate for Payer: PACE Medicare |
$121,371.37
|
| Rate for Payer: PACE SWMI |
$127,759.34
|
| Rate for Payer: PHP Commercial |
$140,535.27
|
| Rate for Payer: PHP Medicare Advantage |
$127,759.34
|
| Rate for Payer: Priority Health Medicare |
$127,759.34
|
| Rate for Payer: Railroad Medicare Medicare |
$127,759.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$127,759.34
|
| Rate for Payer: UHC Exchange |
$198,026.98
|
| Rate for Payer: UHC Medicare Advantage |
$127,759.34
|
| Rate for Payer: UHCCP DNSP |
$127,759.34
|
| Rate for Payer: VA VA |
$127,759.34
|
|
|
MS-DRG 42.00: TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC
|
Facility
|
IP
|
$13,663.25
|
|
|
Service Code
|
MSDRG 069
|
| Min. Negotiated Rate |
$8,374.25 |
| Max. Negotiated Rate |
$13,663.25 |
| Rate for Payer: Aetna Medicare |
$8,815.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,018.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,018.75
|
| Rate for Payer: BCBS MAPPO |
$8,815.00
|
| Rate for Payer: BCN Medicare Advantage |
$8,815.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,815.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,815.00
|
| Rate for Payer: Mclaren Medicare |
$8,815.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,255.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,137.25
|
| Rate for Payer: PACE Medicare |
$8,374.25
|
| Rate for Payer: PACE SWMI |
$8,815.00
|
| Rate for Payer: PHP Commercial |
$9,696.50
|
| Rate for Payer: PHP Medicare Advantage |
$8,815.00
|
| Rate for Payer: Priority Health Medicare |
$8,815.00
|
| Rate for Payer: Railroad Medicare Medicare |
$8,815.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,815.00
|
| Rate for Payer: UHC Exchange |
$13,663.25
|
| Rate for Payer: UHC Medicare Advantage |
$8,815.00
|
| Rate for Payer: UHCCP DNSP |
$8,815.00
|
| Rate for Payer: VA VA |
$8,815.00
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH CC
|
Facility
|
IP
|
$24,000.42
|
|
|
Service Code
|
MSDRG 669
|
| Min. Negotiated Rate |
$14,709.93 |
| Max. Negotiated Rate |
$24,000.42 |
| Rate for Payer: Aetna Medicare |
$15,484.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,355.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,355.17
|
| Rate for Payer: BCBS MAPPO |
$15,484.14
|
| Rate for Payer: BCN Medicare Advantage |
$15,484.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,484.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,484.14
|
| Rate for Payer: Mclaren Medicare |
$15,484.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,258.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,806.76
|
| Rate for Payer: PACE Medicare |
$14,709.93
|
| Rate for Payer: PACE SWMI |
$15,484.14
|
| Rate for Payer: PHP Commercial |
$17,032.55
|
| Rate for Payer: PHP Medicare Advantage |
$15,484.14
|
| Rate for Payer: Priority Health Medicare |
$15,484.14
|
| Rate for Payer: Railroad Medicare Medicare |
$15,484.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,484.14
|
| Rate for Payer: UHC Exchange |
$24,000.42
|
| Rate for Payer: UHC Medicare Advantage |
$15,484.14
|
| Rate for Payer: UHCCP DNSP |
$15,484.14
|
| Rate for Payer: VA VA |
$15,484.14
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$42,932.07
|
|
|
Service Code
|
MSDRG 668
|
| Min. Negotiated Rate |
$26,313.20 |
| Max. Negotiated Rate |
$42,932.07 |
| Rate for Payer: Aetna Medicare |
$27,698.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,622.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,622.64
|
| Rate for Payer: BCBS MAPPO |
$27,698.11
|
| Rate for Payer: BCN Medicare Advantage |
$27,698.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,698.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$27,698.11
|
| Rate for Payer: Mclaren Medicare |
$27,698.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,083.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,852.83
|
| Rate for Payer: PACE Medicare |
$26,313.20
|
| Rate for Payer: PACE SWMI |
$27,698.11
|
| Rate for Payer: PHP Commercial |
$30,467.92
|
| Rate for Payer: PHP Medicare Advantage |
$27,698.11
|
| Rate for Payer: Priority Health Medicare |
$27,698.11
|
| Rate for Payer: Railroad Medicare Medicare |
$27,698.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,698.11
|
| Rate for Payer: UHC Exchange |
$42,932.07
|
| Rate for Payer: UHC Medicare Advantage |
$27,698.11
|
| Rate for Payer: UHCCP DNSP |
$27,698.11
|
| Rate for Payer: VA VA |
$27,698.11
|
|
