|
APR-DRG 42.00: DEPRESSIVE DISORDERS
|
Facility
|
IP
|
$1,599.43
|
|
|
Service Code
|
APR-DRG 7511
|
| Min. Negotiated Rate |
$408.50 |
| Max. Negotiated Rate |
$1,599.43 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$1,599.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$1,599.43
|
|
|
APR-DRG 42.00: DEPRESSIVE DISORDERS
|
Facility
|
IP
|
$2,161.39
|
|
|
Service Code
|
APR-DRG 7512
|
| Min. Negotiated Rate |
$408.50 |
| Max. Negotiated Rate |
$2,161.39 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$2,161.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$2,161.39
|
|
|
APR-DRG 42.00: DIABETES
|
Facility
|
IP
|
$8,256.51
|
|
|
Service Code
|
APR-DRG 4204
|
| Min. Negotiated Rate |
$6,624.65 |
| Max. Negotiated Rate |
$8,256.51 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$8,256.51
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$8,256.51
|
|
|
APR-DRG 42.00: DIABETES
|
Facility
|
IP
|
$2,204.62
|
|
|
Service Code
|
APR-DRG 4201
|
| Min. Negotiated Rate |
$2,079.01 |
| Max. Negotiated Rate |
$2,204.62 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$2,204.62
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$2,204.62
|
|
|
APR-DRG 42.00: DIABETES
|
Facility
|
IP
|
$2,896.26
|
|
|
Service Code
|
APR-DRG 4202
|
| Min. Negotiated Rate |
$2,396.15 |
| Max. Negotiated Rate |
$2,896.26 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$2,896.26
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$2,896.26
|
|
|
APR-DRG 42.00: DIABETES
|
Facility
|
IP
|
$4,409.24
|
|
|
Service Code
|
APR-DRG 4203
|
| Min. Negotiated Rate |
$3,488.51 |
| Max. Negotiated Rate |
$4,409.24 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$4,409.24
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$4,409.24
|
|
|
APR-DRG 42.00: DIGESTIVE MALIGNANCY
|
Facility
|
IP
|
$6,268.03
|
|
|
Service Code
|
APR-DRG 2403
|
| Min. Negotiated Rate |
$5,038.96 |
| Max. Negotiated Rate |
$6,268.03 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$6,268.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$6,268.03
|
|
|
APR-DRG 42.00: DIGESTIVE MALIGNANCY
|
Facility
|
IP
|
$4,510.40
|
|
|
Service Code
|
APR-DRG 2401
|
| Min. Negotiated Rate |
$3,458.22 |
| Max. Negotiated Rate |
$4,510.40 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$3,458.22
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$3,458.22
|
|
|
APR-DRG 42.00: DIGESTIVE MALIGNANCY
|
Facility
|
IP
|
$9,985.62
|
|
|
Service Code
|
APR-DRG 2404
|
| Min. Negotiated Rate |
$8,175.10 |
| Max. Negotiated Rate |
$9,985.62 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$9,985.62
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$9,985.62
|
|
|
APR-DRG 42.00: DIGESTIVE MALIGNANCY
|
Facility
|
IP
|
$4,510.40
|
|
|
Service Code
|
APR-DRG 2402
|
| Min. Negotiated Rate |
$4,279.55 |
| Max. Negotiated Rate |
$4,510.40 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$4,279.55
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$4,279.55
|
|
|
APR-DRG 42.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES
|
Facility
|
IP
|
$7,305.50
|
|
|
Service Code
|
APR-DRG 5173
|
| Min. Negotiated Rate |
$7,188.45 |
| Max. Negotiated Rate |
$7,305.50 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$7,305.50
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$7,305.50
|
|
|
APR-DRG 42.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES
|
Facility
|
IP
|
$3,587.91
|
|
|
Service Code
|
APR-DRG 5171
|
| Min. Negotiated Rate |
$2,607.57 |
| Max. Negotiated Rate |
$3,587.91 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$3,587.91
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$3,587.91
|
|
|
APR-DRG 42.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES
|
Facility
|
IP
|
$11,196.00
|
|
|
Service Code
|
APR-DRG 5174
|
| Min. Negotiated Rate |
$8,985.56 |
| Max. Negotiated Rate |
$11,196.00 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$11,196.00
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$11,196.00
|
|
|
APR-DRG 42.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES
|
Facility
|
IP
|
$4,884.74
|
|
|
Service Code
|
APR-DRG 5172
|
| Min. Negotiated Rate |
$2,889.47 |
| Max. Negotiated Rate |
$4,884.74 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$4,884.74
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$4,884.74
|
|
|
APR-DRG 42.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT
|
Facility
|
IP
|
$4,193.10
|
|
|
Service Code
|
APR-DRG 2842
|
| Min. Negotiated Rate |
$3,840.89 |
| Max. Negotiated Rate |
$4,193.10 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$4,193.10
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$4,193.10
|
|
|
APR-DRG 42.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT
|
Facility
|
IP
|
$9,726.25
|
|
|
Service Code
|
APR-DRG 2844
|
| Min. Negotiated Rate |
$6,060.85 |
| Max. Negotiated Rate |
$9,726.25 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$9,726.25
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$9,726.25
|
|
|
APR-DRG 42.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT
|
Facility
|
IP
|
$5,792.53
|
|
|
Service Code
|
APR-DRG 2843
|
| Min. Negotiated Rate |
$4,228.50 |
| Max. Negotiated Rate |
$5,792.53 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$5,792.53
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$5,792.53
|
|
|
APR-DRG 42.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT
|
Facility
|
IP
|
$3,241.85
|
|
|
Service Code
|
APR-DRG 2841
|
| Min. Negotiated Rate |
$3,112.40 |
| Max. Negotiated Rate |
$3,241.85 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$3,112.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$3,112.40
|
|
|
APR-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$3,285.31
|
|
|
Service Code
|
APR-DRG 2822
|
| Min. Negotiated Rate |
$2,889.47 |
| Max. Negotiated Rate |
$3,285.31 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$3,285.31
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$3,285.31
|
|
|
APR-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$2,377.53
|
|
|
Service Code
|
APR-DRG 2821
|
| Min. Negotiated Rate |
$2,360.91 |
| Max. Negotiated Rate |
$2,377.53 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$2,377.53
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$2,377.53
|
|
|
APR-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$5,360.25
|
|
|
Service Code
|
APR-DRG 2823
|
| Min. Negotiated Rate |
$4,721.82 |
| Max. Negotiated Rate |
$5,360.25 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$5,360.25
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$5,360.25
|
|
|
APR-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$11,945.51
|
|
|
Service Code
|
APR-DRG 2824
|
| Min. Negotiated Rate |
$11,368.91 |
| Max. Negotiated Rate |
$11,945.51 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$11,368.91
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$11,368.91
|
|
|
APR-DRG 42.00: DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$3,155.63
|
|
|
Service Code
|
APR-DRG 2442
|
| Min. Negotiated Rate |
$2,959.95 |
| Max. Negotiated Rate |
$3,155.63 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$3,155.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$3,155.63
|
|
|
APR-DRG 42.00: DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$2,819.00
|
|
|
Service Code
|
APR-DRG 2441
|
| Min. Negotiated Rate |
$2,291.07 |
| Max. Negotiated Rate |
$2,819.00 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$2,291.07
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$2,291.07
|
|
|
APR-DRG 42.00: DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$4,927.97
|
|
|
Service Code
|
APR-DRG 2443
|
| Min. Negotiated Rate |
$2,995.19 |
| Max. Negotiated Rate |
$4,927.97 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$4,927.97
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$4,927.97
|
|