|
MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$15,815.33
|
|
|
Service Code
|
MSDRG 670
|
| Min. Negotiated Rate |
$9,693.27 |
| Max. Negotiated Rate |
$15,815.33 |
| Rate for Payer: Aetna Medicare |
$10,203.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,754.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,754.30
|
| Rate for Payer: BCBS MAPPO |
$10,203.44
|
| Rate for Payer: BCN Medicare Advantage |
$10,203.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,203.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,203.44
|
| Rate for Payer: Mclaren Medicare |
$10,203.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,713.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,733.96
|
| Rate for Payer: PACE Medicare |
$9,693.27
|
| Rate for Payer: PACE SWMI |
$10,203.44
|
| Rate for Payer: PHP Commercial |
$11,223.78
|
| Rate for Payer: PHP Medicare Advantage |
$10,203.44
|
| Rate for Payer: Priority Health Medicare |
$10,203.44
|
| Rate for Payer: Railroad Medicare Medicare |
$10,203.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,203.44
|
| Rate for Payer: UHC Exchange |
$15,815.33
|
| Rate for Payer: UHC Medicare Advantage |
$10,203.44
|
| Rate for Payer: UHCCP DNSP |
$10,203.44
|
| Rate for Payer: VA VA |
$10,203.44
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITH CC/MCC
|
Facility
|
IP
|
$22,596.61
|
|
|
Service Code
|
MSDRG 713
|
| Min. Negotiated Rate |
$13,849.54 |
| Max. Negotiated Rate |
$22,596.61 |
| Rate for Payer: Aetna Medicare |
$14,578.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,223.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,223.08
|
| Rate for Payer: BCBS MAPPO |
$14,578.46
|
| Rate for Payer: BCN Medicare Advantage |
$14,578.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,578.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,578.46
|
| Rate for Payer: Mclaren Medicare |
$14,578.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,307.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,765.23
|
| Rate for Payer: PACE Medicare |
$13,849.54
|
| Rate for Payer: PACE SWMI |
$14,578.46
|
| Rate for Payer: PHP Commercial |
$16,036.31
|
| Rate for Payer: PHP Medicare Advantage |
$14,578.46
|
| Rate for Payer: Priority Health Medicare |
$14,578.46
|
| Rate for Payer: Railroad Medicare Medicare |
$14,578.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,578.46
|
| Rate for Payer: UHC Exchange |
$22,596.61
|
| Rate for Payer: UHC Medicare Advantage |
$14,578.46
|
| Rate for Payer: UHCCP DNSP |
$14,578.46
|
| Rate for Payer: VA VA |
$14,578.46
|
|
|
MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$15,594.05
|
|
|
Service Code
|
MSDRG 714
|
| Min. Negotiated Rate |
$9,557.65 |
| Max. Negotiated Rate |
$15,594.05 |
| Rate for Payer: Aetna Medicare |
$10,060.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,575.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,575.85
|
| Rate for Payer: BCBS MAPPO |
$10,060.68
|
| Rate for Payer: BCN Medicare Advantage |
$10,060.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,060.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,060.68
|
| Rate for Payer: Mclaren Medicare |
$10,060.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,563.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,569.78
|
| Rate for Payer: PACE Medicare |
$9,557.65
|
| Rate for Payer: PACE SWMI |
$10,060.68
|
| Rate for Payer: PHP Commercial |
$11,066.75
|
| Rate for Payer: PHP Medicare Advantage |
$10,060.68
|
| Rate for Payer: Priority Health Medicare |
$10,060.68
|
| Rate for Payer: Railroad Medicare Medicare |
$10,060.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,060.68
|
| Rate for Payer: UHC Exchange |
$15,594.05
|
| Rate for Payer: UHC Medicare Advantage |
$10,060.68
|
| Rate for Payer: UHCCP DNSP |
$10,060.68
|
| Rate for Payer: VA VA |
$10,060.68
|
|
|
MS-DRG 42.00: TRAUMATIC INJURY WITH MCC
|
Facility
|
IP
|
$24,979.65
|
|
|
Service Code
|
MSDRG 913
|
| Min. Negotiated Rate |
$15,310.10 |
| Max. Negotiated Rate |
$24,979.65 |
| Rate for Payer: Aetna Medicare |
$16,115.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,144.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,144.88
|
| Rate for Payer: BCBS MAPPO |
$16,115.90
|
| Rate for Payer: BCN Medicare Advantage |
$16,115.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,115.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,115.90
|
| Rate for Payer: Mclaren Medicare |
$16,115.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,921.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,533.28
|
| Rate for Payer: PACE Medicare |
$15,310.10
|
| Rate for Payer: PACE SWMI |
$16,115.90
|
| Rate for Payer: PHP Commercial |
$17,727.49
|
| Rate for Payer: PHP Medicare Advantage |
$16,115.90
|
| Rate for Payer: Priority Health Medicare |
$16,115.90
|
| Rate for Payer: Railroad Medicare Medicare |
$16,115.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,115.90
|
| Rate for Payer: UHC Exchange |
$24,979.65
|
| Rate for Payer: UHC Medicare Advantage |
$16,115.90
|
| Rate for Payer: UHCCP DNSP |
$16,115.90
|
| Rate for Payer: VA VA |
$16,115.90
|
|
|
MS-DRG 42.00: TRAUMATIC INJURY WITHOUT MCC
|
Facility
|
IP
|
$15,271.78
|
|
|
Service Code
|
MSDRG 914
|
| Min. Negotiated Rate |
$9,360.12 |
| Max. Negotiated Rate |
$15,271.78 |
| Rate for Payer: Aetna Medicare |
$9,852.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,315.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,315.95
|
| Rate for Payer: BCBS MAPPO |
$9,852.76
|
| Rate for Payer: BCN Medicare Advantage |
$9,852.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,852.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,852.76
|
| Rate for Payer: Mclaren Medicare |
$9,852.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,345.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,330.67
|
| Rate for Payer: PACE Medicare |
$9,360.12
|
| Rate for Payer: PACE SWMI |
$9,852.76
|
| Rate for Payer: PHP Commercial |
$10,838.04
|
| Rate for Payer: PHP Medicare Advantage |
$9,852.76
|
| Rate for Payer: Priority Health Medicare |
$9,852.76
|
| Rate for Payer: Railroad Medicare Medicare |
$9,852.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,852.76
|
| Rate for Payer: UHC Exchange |
$15,271.78
|
| Rate for Payer: UHC Medicare Advantage |
$9,852.76
|
| Rate for Payer: UHCCP DNSP |
$9,852.76
|
| Rate for Payer: VA VA |
$9,852.76
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC
|
Facility
|
IP
|
$20,737.73
|
|
|
Service Code
|
MSDRG 086
|
| Min. Negotiated Rate |
$12,710.22 |
| Max. Negotiated Rate |
$20,737.73 |
| Rate for Payer: Aetna Medicare |
$13,379.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,723.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,723.97
|
| Rate for Payer: BCBS MAPPO |
$13,379.18
|
| Rate for Payer: BCN Medicare Advantage |
$13,379.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,379.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,379.18
|
| Rate for Payer: Mclaren Medicare |
$13,379.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,048.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,386.06
|
| Rate for Payer: PACE Medicare |
$12,710.22
|
| Rate for Payer: PACE SWMI |
$13,379.18
|
| Rate for Payer: PHP Commercial |
$14,717.10
|
| Rate for Payer: PHP Medicare Advantage |
$13,379.18
|
| Rate for Payer: Priority Health Medicare |
$13,379.18
|
| Rate for Payer: Railroad Medicare Medicare |
$13,379.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,379.18
|
| Rate for Payer: UHC Exchange |
$20,737.73
|
| Rate for Payer: UHC Medicare Advantage |
$13,379.18
|
| Rate for Payer: UHCCP DNSP |
$13,379.18
|
| Rate for Payer: VA VA |
$13,379.18
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC
|
Facility
|
IP
|
$21,827.61
|
|
|
Service Code
|
MSDRG 083
|
| Min. Negotiated Rate |
$13,378.21 |
| Max. Negotiated Rate |
$21,827.61 |
| Rate for Payer: Aetna Medicare |
$14,082.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,602.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,602.91
|
| Rate for Payer: BCBS MAPPO |
$14,082.33
|
| Rate for Payer: BCN Medicare Advantage |
$14,082.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,082.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,082.33
|
| Rate for Payer: Mclaren Medicare |
$14,082.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,786.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,194.68
|
| Rate for Payer: PACE Medicare |
$13,378.21
|
| Rate for Payer: PACE SWMI |
$14,082.33
|
| Rate for Payer: PHP Commercial |
$15,490.56
|
| Rate for Payer: PHP Medicare Advantage |
$14,082.33
|
| Rate for Payer: Priority Health Medicare |
$14,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$14,082.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,082.33
|
| Rate for Payer: UHC Exchange |
$21,827.61
|
| Rate for Payer: UHC Medicare Advantage |
$14,082.33
|
| Rate for Payer: UHCCP DNSP |
$14,082.33
|
| Rate for Payer: VA VA |
$14,082.33
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC
|
Facility
|
IP
|
$33,937.89
|
|
|
Service Code
|
MSDRG 085
|
| Min. Negotiated Rate |
$20,800.64 |
| Max. Negotiated Rate |
$33,937.89 |
| Rate for Payer: Aetna Medicare |
$21,895.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,369.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,369.26
|
| Rate for Payer: BCBS MAPPO |
$21,895.41
|
| Rate for Payer: BCN Medicare Advantage |
$21,895.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,895.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,895.41
|
| Rate for Payer: Mclaren Medicare |
$21,895.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,990.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,179.72
|
| Rate for Payer: PACE Medicare |
$20,800.64
|
| Rate for Payer: PACE SWMI |
$21,895.41
|
| Rate for Payer: PHP Commercial |
$24,084.95
|
| Rate for Payer: PHP Medicare Advantage |
$21,895.41
|
| Rate for Payer: Priority Health Medicare |
$21,895.41
|
| Rate for Payer: Railroad Medicare Medicare |
$21,895.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,895.41
|
| Rate for Payer: UHC Exchange |
$33,937.89
|
| Rate for Payer: UHC Medicare Advantage |
$21,895.41
|
| Rate for Payer: UHCCP DNSP |
$21,895.41
|
| Rate for Payer: VA VA |
$21,895.41
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC
|
Facility
|
IP
|
$34,687.51
|
|
|
Service Code
|
MSDRG 082
|
| Min. Negotiated Rate |
$21,260.09 |
| Max. Negotiated Rate |
$34,687.51 |
| Rate for Payer: Aetna Medicare |
$22,379.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,973.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,973.80
|
| Rate for Payer: BCBS MAPPO |
$22,379.04
|
| Rate for Payer: BCN Medicare Advantage |
$22,379.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,379.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,379.04
|
| Rate for Payer: Mclaren Medicare |
$22,379.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,497.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,735.90
|
| Rate for Payer: PACE Medicare |
$21,260.09
|
| Rate for Payer: PACE SWMI |
$22,379.04
|
| Rate for Payer: PHP Commercial |
$24,616.94
|
| Rate for Payer: PHP Medicare Advantage |
$22,379.04
|
| Rate for Payer: Priority Health Medicare |
$22,379.04
|
| Rate for Payer: Railroad Medicare Medicare |
$22,379.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,379.04
|
| Rate for Payer: UHC Exchange |
$34,687.51
|
| Rate for Payer: UHC Medicare Advantage |
$22,379.04
|
| Rate for Payer: UHCCP DNSP |
$22,379.04
|
| Rate for Payer: VA VA |
$22,379.04
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC
|
Facility
|
IP
|
$14,823.67
|
|
|
Service Code
|
MSDRG 087
|
| Min. Negotiated Rate |
$9,085.48 |
| Max. Negotiated Rate |
$14,823.67 |
| Rate for Payer: Aetna Medicare |
$9,563.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,954.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,954.58
|
| Rate for Payer: BCBS MAPPO |
$9,563.66
|
| Rate for Payer: BCN Medicare Advantage |
$9,563.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,563.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,563.66
|
| Rate for Payer: Mclaren Medicare |
$9,563.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,041.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,998.21
|
| Rate for Payer: PACE Medicare |
$9,085.48
|
| Rate for Payer: PACE SWMI |
$9,563.66
|
| Rate for Payer: PHP Commercial |
$10,520.03
|
| Rate for Payer: PHP Medicare Advantage |
$9,563.66
|
| Rate for Payer: Priority Health Medicare |
$9,563.66
|
| Rate for Payer: Railroad Medicare Medicare |
$9,563.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,563.66
|
| Rate for Payer: UHC Exchange |
$14,823.67
|
| Rate for Payer: UHC Medicare Advantage |
$9,563.66
|
| Rate for Payer: UHCCP DNSP |
$9,563.66
|
| Rate for Payer: VA VA |
$9,563.66
|
|
|
MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC
|
Facility
|
IP
|
$15,820.87
|
|
|
Service Code
|
MSDRG 084
|
| Min. Negotiated Rate |
$9,696.66 |
| Max. Negotiated Rate |
$15,820.87 |
| Rate for Payer: Aetna Medicare |
$10,207.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,758.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,758.76
|
| Rate for Payer: BCBS MAPPO |
$10,207.01
|
| Rate for Payer: BCN Medicare Advantage |
$10,207.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,207.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,207.01
|
| Rate for Payer: Mclaren Medicare |
$10,207.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,717.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,738.06
|
| Rate for Payer: PACE Medicare |
$9,696.66
|
| Rate for Payer: PACE SWMI |
$10,207.01
|
| Rate for Payer: PHP Commercial |
$11,227.71
|
| Rate for Payer: PHP Medicare Advantage |
$10,207.01
|
| Rate for Payer: Priority Health Medicare |
$10,207.01
|
| Rate for Payer: Railroad Medicare Medicare |
$10,207.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,207.01
|
| Rate for Payer: UHC Exchange |
$15,820.87
|
| Rate for Payer: UHC Medicare Advantage |
$10,207.01
|
| Rate for Payer: UHCCP DNSP |
$10,207.01
|
| Rate for Payer: VA VA |
$10,207.01
|
|
|
MS-DRG 42.00: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC
|
Facility
|
IP
|
$23,145.69
|
|
|
Service Code
|
MSDRG 604
|
| Min. Negotiated Rate |
$14,186.07 |
| Max. Negotiated Rate |
$23,145.69 |
| Rate for Payer: Aetna Medicare |
$14,932.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,665.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,665.88
|
| Rate for Payer: BCBS MAPPO |
$14,932.70
|
| Rate for Payer: BCN Medicare Advantage |
$14,932.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,932.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,932.70
|
| Rate for Payer: Mclaren Medicare |
$14,932.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,679.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,172.60
|
| Rate for Payer: PACE Medicare |
$14,186.07
|
| Rate for Payer: PACE SWMI |
$14,932.70
|
| Rate for Payer: PHP Commercial |
$16,425.97
|
| Rate for Payer: PHP Medicare Advantage |
$14,932.70
|
| Rate for Payer: Priority Health Medicare |
$14,932.70
|
| Rate for Payer: Railroad Medicare Medicare |
$14,932.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,932.70
|
| Rate for Payer: UHC Exchange |
$23,145.69
|
| Rate for Payer: UHC Medicare Advantage |
$14,932.70
|
| Rate for Payer: UHCCP DNSP |
$14,932.70
|
| Rate for Payer: VA VA |
$14,932.70
|
|
|
MS-DRG 42.00: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC
|
Facility
|
IP
|
$15,372.75
|
|
|
Service Code
|
MSDRG 605
|
| Min. Negotiated Rate |
$9,422.00 |
| Max. Negotiated Rate |
$15,372.75 |
| Rate for Payer: Aetna Medicare |
$9,917.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,397.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,397.38
|
| Rate for Payer: BCBS MAPPO |
$9,917.90
|
| Rate for Payer: BCN Medicare Advantage |
$9,917.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,917.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,917.90
|
| Rate for Payer: Mclaren Medicare |
$9,917.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,413.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,405.58
|
| Rate for Payer: PACE Medicare |
$9,422.00
|
| Rate for Payer: PACE SWMI |
$9,917.90
|
| Rate for Payer: PHP Commercial |
$10,909.69
|
| Rate for Payer: PHP Medicare Advantage |
$9,917.90
|
| Rate for Payer: Priority Health Medicare |
$9,917.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9,917.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,917.90
|
| Rate for Payer: UHC Exchange |
$15,372.75
|
| Rate for Payer: UHC Medicare Advantage |
$9,917.90
|
| Rate for Payer: UHCCP DNSP |
$9,917.90
|
| Rate for Payer: VA VA |
$9,917.90
|
|
|
MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC
|
Facility
|
IP
|
$71,797.02
|
|
|
Service Code
|
MSDRG 278
|
| Min. Negotiated Rate |
$44,004.63 |
| Max. Negotiated Rate |
$71,797.02 |
| Rate for Payer: Aetna Medicare |
$46,320.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57,900.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57,900.82
|
| Rate for Payer: BCBS MAPPO |
$46,320.66
|
| Rate for Payer: BCN Medicare Advantage |
$46,320.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,320.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$46,320.66
|
| Rate for Payer: Mclaren Medicare |
$46,320.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48,636.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53,268.76
|
| Rate for Payer: PACE Medicare |
$44,004.63
|
| Rate for Payer: PACE SWMI |
$46,320.66
|
| Rate for Payer: PHP Commercial |
$50,952.73
|
| Rate for Payer: PHP Medicare Advantage |
$46,320.66
|
| Rate for Payer: Priority Health Medicare |
$46,320.66
|
| Rate for Payer: Railroad Medicare Medicare |
$46,320.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$46,320.66
|
| Rate for Payer: UHC Exchange |
$71,797.02
|
| Rate for Payer: UHC Medicare Advantage |
$46,320.66
|
| Rate for Payer: UHCCP DNSP |
$46,320.66
|
| Rate for Payer: VA VA |
$46,320.66
|
|
|
MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC
|
Facility
|
IP
|
$46,916.73
|
|
|
Service Code
|
MSDRG 279
|
| Min. Negotiated Rate |
$28,755.42 |
| Max. Negotiated Rate |
$46,916.73 |
| Rate for Payer: Aetna Medicare |
$30,268.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,836.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,836.07
|
| Rate for Payer: BCBS MAPPO |
$30,268.86
|
| Rate for Payer: BCN Medicare Advantage |
$30,268.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,268.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$30,268.86
|
| Rate for Payer: Mclaren Medicare |
$30,268.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,782.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,809.19
|
| Rate for Payer: PACE Medicare |
$28,755.42
|
| Rate for Payer: PACE SWMI |
$30,268.86
|
| Rate for Payer: PHP Commercial |
$33,295.75
|
| Rate for Payer: PHP Medicare Advantage |
$30,268.86
|
| Rate for Payer: Priority Health Medicare |
$30,268.86
|
| Rate for Payer: Railroad Medicare Medicare |
$30,268.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$30,268.86
|
| Rate for Payer: UHC Exchange |
$46,916.73
|
| Rate for Payer: UHC Medicare Advantage |
$30,268.86
|
| Rate for Payer: UHCCP DNSP |
$30,268.86
|
| Rate for Payer: VA VA |
$30,268.86
|
|
|
MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM
|
Facility
|
IP
|
$45,038.52
|
|
|
Service Code
|
MSDRG 173
|
| Min. Negotiated Rate |
$27,604.25 |
| Max. Negotiated Rate |
$45,038.52 |
| Rate for Payer: Aetna Medicare |
$29,057.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,321.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,321.39
|
| Rate for Payer: BCBS MAPPO |
$29,057.11
|
| Rate for Payer: BCN Medicare Advantage |
$29,057.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,057.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$29,057.11
|
| Rate for Payer: Mclaren Medicare |
$29,057.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,509.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,415.68
|
| Rate for Payer: PACE Medicare |
$27,604.25
|
| Rate for Payer: PACE SWMI |
$29,057.11
|
| Rate for Payer: PHP Commercial |
$31,962.82
|
| Rate for Payer: PHP Medicare Advantage |
$29,057.11
|
| Rate for Payer: Priority Health Medicare |
$29,057.11
|
| Rate for Payer: Railroad Medicare Medicare |
$29,057.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,057.11
|
| Rate for Payer: UHC Exchange |
$45,038.52
|
| Rate for Payer: UHC Medicare Advantage |
$29,057.11
|
| Rate for Payer: UHCCP DNSP |
$29,057.11
|
| Rate for Payer: VA VA |
$29,057.11
|
|
|
MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$20,082.17
|
|
|
Service Code
|
MSDRG 383
|
| Min. Negotiated Rate |
$12,308.43 |
| Max. Negotiated Rate |
$20,082.17 |
| Rate for Payer: Aetna Medicare |
$12,956.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,195.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,195.30
|
| Rate for Payer: BCBS MAPPO |
$12,956.24
|
| Rate for Payer: BCN Medicare Advantage |
$12,956.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,956.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,956.24
|
| Rate for Payer: Mclaren Medicare |
$12,956.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,604.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,899.68
|
| Rate for Payer: PACE Medicare |
$12,308.43
|
| Rate for Payer: PACE SWMI |
$12,956.24
|
| Rate for Payer: PHP Commercial |
$14,251.86
|
| Rate for Payer: PHP Medicare Advantage |
$12,956.24
|
| Rate for Payer: Priority Health Medicare |
$12,956.24
|
| Rate for Payer: Railroad Medicare Medicare |
$12,956.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,956.24
|
| Rate for Payer: UHC Exchange |
$20,082.17
|
| Rate for Payer: UHC Medicare Advantage |
$12,956.24
|
| Rate for Payer: UHCCP DNSP |
$12,956.24
|
| Rate for Payer: VA VA |
$12,956.24
|
|
|
MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITHOUT MCC
|
Facility
|
IP
|
$14,624.50
|
|
|
Service Code
|
MSDRG 384
|
| Min. Negotiated Rate |
$8,963.40 |
| Max. Negotiated Rate |
$14,624.50 |
| Rate for Payer: Aetna Medicare |
$9,435.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,793.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,793.95
|
| Rate for Payer: BCBS MAPPO |
$9,435.16
|
| Rate for Payer: BCN Medicare Advantage |
$9,435.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,435.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,435.16
|
| Rate for Payer: Mclaren Medicare |
$9,435.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,906.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,850.43
|
| Rate for Payer: PACE Medicare |
$8,963.40
|
| Rate for Payer: PACE SWMI |
$9,435.16
|
| Rate for Payer: PHP Commercial |
$10,378.68
|
| Rate for Payer: PHP Medicare Advantage |
$9,435.16
|
| Rate for Payer: Priority Health Medicare |
$9,435.16
|
| Rate for Payer: Railroad Medicare Medicare |
$9,435.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,435.16
|
| Rate for Payer: UHC Exchange |
$14,624.50
|
| Rate for Payer: UHC Medicare Advantage |
$9,435.16
|
| Rate for Payer: UHCCP DNSP |
$9,435.16
|
| Rate for Payer: VA VA |
$9,435.16
|
|
|
MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC
|
Facility
|
IP
|
$26,022.49
|
|
|
Service Code
|
MSDRG 256
|
| Min. Negotiated Rate |
$15,949.26 |
| Max. Negotiated Rate |
$26,022.49 |
| Rate for Payer: Aetna Medicare |
$16,788.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,985.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,985.88
|
| Rate for Payer: BCBS MAPPO |
$16,788.70
|
| Rate for Payer: BCN Medicare Advantage |
$16,788.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,788.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,788.70
|
| Rate for Payer: Mclaren Medicare |
$16,788.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,628.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,307.01
|
| Rate for Payer: PACE Medicare |
$15,949.26
|
| Rate for Payer: PACE SWMI |
$16,788.70
|
| Rate for Payer: PHP Commercial |
$18,467.57
|
| Rate for Payer: PHP Medicare Advantage |
$16,788.70
|
| Rate for Payer: Priority Health Medicare |
$16,788.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16,788.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,788.70
|
| Rate for Payer: UHC Exchange |
$26,022.49
|
| Rate for Payer: UHC Medicare Advantage |
$16,788.70
|
| Rate for Payer: UHCCP DNSP |
$16,788.70
|
| Rate for Payer: VA VA |
$16,788.70
|
|
|
MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC
|
Facility
|
IP
|
$38,785.59
|
|
|
Service Code
|
MSDRG 255
|
| Min. Negotiated Rate |
$23,771.81 |
| Max. Negotiated Rate |
$38,785.59 |
| Rate for Payer: Aetna Medicare |
$25,022.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,278.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,278.70
|
| Rate for Payer: BCBS MAPPO |
$25,022.96
|
| Rate for Payer: BCN Medicare Advantage |
$25,022.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,022.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,022.96
|
| Rate for Payer: Mclaren Medicare |
$25,022.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,274.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,776.40
|
| Rate for Payer: PACE Medicare |
$23,771.81
|
| Rate for Payer: PACE SWMI |
$25,022.96
|
| Rate for Payer: PHP Commercial |
$27,525.26
|
| Rate for Payer: PHP Medicare Advantage |
$25,022.96
|
| Rate for Payer: Priority Health Medicare |
$25,022.96
|
| Rate for Payer: Railroad Medicare Medicare |
$25,022.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,022.96
|
| Rate for Payer: UHC Exchange |
$38,785.59
|
| Rate for Payer: UHC Medicare Advantage |
$25,022.96
|
| Rate for Payer: UHCCP DNSP |
$25,022.96
|
| Rate for Payer: VA VA |
$25,022.96
|
|
|
MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$14,932.93
|
|
|
Service Code
|
MSDRG 257
|
| Min. Negotiated Rate |
$9,152.44 |
| Max. Negotiated Rate |
$14,932.93 |
| Rate for Payer: Aetna Medicare |
$9,634.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,042.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,042.69
|
| Rate for Payer: BCBS MAPPO |
$9,634.15
|
| Rate for Payer: BCN Medicare Advantage |
$9,634.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,634.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,634.15
|
| Rate for Payer: Mclaren Medicare |
$9,634.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,115.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,079.27
|
| Rate for Payer: PACE Medicare |
$9,152.44
|
| Rate for Payer: PACE SWMI |
$9,634.15
|
| Rate for Payer: PHP Commercial |
$10,597.57
|
| Rate for Payer: PHP Medicare Advantage |
$9,634.15
|
| Rate for Payer: Priority Health Medicare |
$9,634.15
|
| Rate for Payer: Railroad Medicare Medicare |
$9,634.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,634.15
|
| Rate for Payer: UHC Exchange |
$14,932.93
|
| Rate for Payer: UHC Medicare Advantage |
$9,634.15
|
| Rate for Payer: UHCCP DNSP |
$9,634.15
|
| Rate for Payer: VA VA |
$9,634.15
|
|
|
MS-DRG 42.00: URETHRAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$26,437.42
|
|
|
Service Code
|
MSDRG 671
|
| Min. Negotiated Rate |
$16,203.58 |
| Max. Negotiated Rate |
$26,437.42 |
| Rate for Payer: Aetna Medicare |
$17,056.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,320.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,320.50
|
| Rate for Payer: BCBS MAPPO |
$17,056.40
|
| Rate for Payer: BCN Medicare Advantage |
$17,056.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,056.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,056.40
|
| Rate for Payer: Mclaren Medicare |
$17,056.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,909.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,614.86
|
| Rate for Payer: PACE Medicare |
$16,203.58
|
| Rate for Payer: PACE SWMI |
$17,056.40
|
| Rate for Payer: PHP Commercial |
$18,762.04
|
| Rate for Payer: PHP Medicare Advantage |
$17,056.40
|
| Rate for Payer: Priority Health Medicare |
$17,056.40
|
| Rate for Payer: Railroad Medicare Medicare |
$17,056.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,056.40
|
| Rate for Payer: UHC Exchange |
$26,437.42
|
| Rate for Payer: UHC Medicare Advantage |
$17,056.40
|
| Rate for Payer: UHCCP DNSP |
$17,056.40
|
| Rate for Payer: VA VA |
$17,056.40
|
|
|
MS-DRG 42.00: URETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$17,733.67
|
|
|
Service Code
|
MSDRG 672
|
| Min. Negotiated Rate |
$10,869.03 |
| Max. Negotiated Rate |
$17,733.67 |
| Rate for Payer: Aetna Medicare |
$11,441.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,301.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,301.35
|
| Rate for Payer: BCBS MAPPO |
$11,441.08
|
| Rate for Payer: BCN Medicare Advantage |
$11,441.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,441.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,441.08
|
| Rate for Payer: Mclaren Medicare |
$11,441.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,013.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,157.24
|
| Rate for Payer: PACE Medicare |
$10,869.03
|
| Rate for Payer: PACE SWMI |
$11,441.08
|
| Rate for Payer: PHP Commercial |
$12,585.19
|
| Rate for Payer: PHP Medicare Advantage |
$11,441.08
|
| Rate for Payer: Priority Health Medicare |
$11,441.08
|
| Rate for Payer: Railroad Medicare Medicare |
$11,441.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,441.08
|
| Rate for Payer: UHC Exchange |
$17,733.67
|
| Rate for Payer: UHC Medicare Advantage |
$11,441.08
|
| Rate for Payer: UHCCP DNSP |
$11,441.08
|
| Rate for Payer: VA VA |
$11,441.08
|
|
|
MS-DRG 42.00: URETHRAL STRICTURE
|
Facility
|
IP
|
$16,452.92
|
|
|
Service Code
|
MSDRG 697
|
| Min. Negotiated Rate |
$10,084.05 |
| Max. Negotiated Rate |
$16,452.92 |
| Rate for Payer: Aetna Medicare |
$10,614.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,268.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,268.49
|
| Rate for Payer: BCBS MAPPO |
$10,614.79
|
| Rate for Payer: BCN Medicare Advantage |
$10,614.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,614.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,614.79
|
| Rate for Payer: Mclaren Medicare |
$10,614.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,145.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,207.01
|
| Rate for Payer: PACE Medicare |
$10,084.05
|
| Rate for Payer: PACE SWMI |
$10,614.79
|
| Rate for Payer: PHP Commercial |
$11,676.27
|
| Rate for Payer: PHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Priority Health Medicare |
$10,614.79
|
| Rate for Payer: Railroad Medicare Medicare |
$10,614.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,614.79
|
| Rate for Payer: UHC Exchange |
$16,452.92
|
| Rate for Payer: UHC Medicare Advantage |
$10,614.79
|
| Rate for Payer: UHCCP DNSP |
$10,614.79
|
| Rate for Payer: VA VA |
$10,614.79
|
|
|
MS-DRG 42.00: URINARY STONES WITH MCC
|
Facility
|
IP
|
$22,934.08
|
|
|
Service Code
|
MSDRG 693
|
| Min. Negotiated Rate |
$14,056.37 |
| Max. Negotiated Rate |
$22,934.08 |
| Rate for Payer: Aetna Medicare |
$14,796.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,495.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,495.22
|
| Rate for Payer: BCBS MAPPO |
$14,796.18
|
| Rate for Payer: BCN Medicare Advantage |
$14,796.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,796.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,796.18
|
| Rate for Payer: Mclaren Medicare |
$14,796.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,535.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,015.61
|
| Rate for Payer: PACE Medicare |
$14,056.37
|
| Rate for Payer: PACE SWMI |
$14,796.18
|
| Rate for Payer: PHP Commercial |
$16,275.80
|
| Rate for Payer: PHP Medicare Advantage |
$14,796.18
|
| Rate for Payer: Priority Health Medicare |
$14,796.18
|
| Rate for Payer: Railroad Medicare Medicare |
$14,796.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,796.18
|
| Rate for Payer: UHC Exchange |
$22,934.08
|
| Rate for Payer: UHC Medicare Advantage |
$14,796.18
|
| Rate for Payer: UHCCP DNSP |
$14,796.18
|
| Rate for Payer: VA VA |
$14,796.18
|
|
