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Charge Type Price  
Service Code APR-DRG 7114
Hospital Charge Code APRDRG 7114
Min. Negotiated Rate $15,448.40
Max. Negotiated Rate $59,370.43
Rate for Payer: Buckeye Health Medicaid OOS $15,448.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $59,370.43
Rate for Payer: Managed Health Services Medicaid $59,370.43
Rate for Payer: MDWise Medicaid $59,370.43
Rate for Payer: Molina Healthcare of OH Medicare $15,448.40
Service Code APR-DRG 7201
Hospital Charge Code APRDRG 7201
Min. Negotiated Rate $1,817.85
Max. Negotiated Rate $8,541.92
Rate for Payer: Buckeye Health Medicaid OOS $1,817.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $8,541.92
Rate for Payer: Managed Health Services Medicaid $8,541.92
Rate for Payer: MDWise Medicaid $8,541.92
Rate for Payer: Molina Healthcare of OH Medicare $1,817.85
Service Code APR-DRG 7202
Hospital Charge Code APRDRG 7202
Min. Negotiated Rate $2,306.82
Max. Negotiated Rate $10,888.92
Rate for Payer: Buckeye Health Medicaid OOS $2,306.82
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $10,888.92
Rate for Payer: Managed Health Services Medicaid $10,888.92
Rate for Payer: MDWise Medicaid $10,888.92
Rate for Payer: Molina Healthcare of OH Medicare $2,306.82
Service Code APR-DRG 7203
Hospital Charge Code APRDRG 7203
Min. Negotiated Rate $3,652.36
Max. Negotiated Rate $16,243.96
Rate for Payer: Buckeye Health Medicaid OOS $3,652.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $16,243.96
Rate for Payer: Managed Health Services Medicaid $16,243.96
Rate for Payer: MDWise Medicaid $16,243.96
Rate for Payer: Molina Healthcare of OH Medicare $3,652.36
Service Code APR-DRG 7204
Hospital Charge Code APRDRG 7204
Min. Negotiated Rate $7,909.61
Max. Negotiated Rate $37,412.53
Rate for Payer: Buckeye Health Medicaid OOS $7,909.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $37,412.53
Rate for Payer: Managed Health Services Medicaid $37,412.53
Rate for Payer: MDWise Medicaid $37,412.53
Rate for Payer: Molina Healthcare of OH Medicare $7,909.61
Service Code APR-DRG 7211
Hospital Charge Code APRDRG 7211
Min. Negotiated Rate $2,071.78
Max. Negotiated Rate $9,043.88
Rate for Payer: Buckeye Health Medicaid OOS $2,071.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $9,043.88
Rate for Payer: Managed Health Services Medicaid $9,043.88
Rate for Payer: MDWise Medicaid $9,043.88
Rate for Payer: Molina Healthcare of OH Medicare $2,071.78
Service Code APR-DRG 7212
Hospital Charge Code APRDRG 7212
Min. Negotiated Rate $2,555.31
Max. Negotiated Rate $12,079.06
Rate for Payer: Buckeye Health Medicaid OOS $2,555.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $12,079.06
Rate for Payer: Managed Health Services Medicaid $12,079.06
Rate for Payer: MDWise Medicaid $12,079.06
Rate for Payer: Molina Healthcare of OH Medicare $2,555.31
Service Code APR-DRG 7213
Hospital Charge Code APRDRG 7213
Min. Negotiated Rate $4,806.73
Max. Negotiated Rate $20,053.66
Rate for Payer: Buckeye Health Medicaid OOS $4,806.73
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $20,053.66
Rate for Payer: Managed Health Services Medicaid $20,053.66
Rate for Payer: MDWise Medicaid $20,053.66
Rate for Payer: Molina Healthcare of OH Medicare $4,806.73
Service Code APR-DRG 7214
Hospital Charge Code APRDRG 7214
Min. Negotiated Rate $8,145.60
Max. Negotiated Rate $34,408.19
Rate for Payer: Buckeye Health Medicaid OOS $8,145.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $34,408.19
Rate for Payer: Managed Health Services Medicaid $34,408.19
Rate for Payer: MDWise Medicaid $34,408.19
Rate for Payer: Molina Healthcare of OH Medicare $8,145.60
Service Code APR-DRG 7221
Hospital Charge Code APRDRG 7221
Min. Negotiated Rate $1,861.08
Max. Negotiated Rate $5,495.64
Rate for Payer: Buckeye Health Medicaid OOS $1,861.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $5,495.64
Rate for Payer: Managed Health Services Medicaid $5,495.64
Rate for Payer: MDWise Medicaid $5,495.64
Rate for Payer: Molina Healthcare of OH Medicare $1,861.08
Service Code APR-DRG 7222
Hospital Charge Code APRDRG 7222
Min. Negotiated Rate $1,990.45
Max. Negotiated Rate $8,069.56
Rate for Payer: Buckeye Health Medicaid OOS $1,990.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $8,069.56
Rate for Payer: Managed Health Services Medicaid $8,069.56
Rate for Payer: MDWise Medicaid $8,069.56
Rate for Payer: Molina Healthcare of OH Medicare $1,990.45
Service Code APR-DRG 7223
Hospital Charge Code APRDRG 7223
Min. Negotiated Rate $3,050.04
Max. Negotiated Rate $9,009.35
Rate for Payer: Buckeye Health Medicaid OOS $3,050.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $9,009.35
Rate for Payer: Managed Health Services Medicaid $9,009.35
Rate for Payer: MDWise Medicaid $9,009.35
Rate for Payer: Molina Healthcare of OH Medicare $3,050.04
Service Code APR-DRG 7224
Hospital Charge Code APRDRG 7224
Min. Negotiated Rate $3,872.35
Max. Negotiated Rate $13,102.71
Rate for Payer: Buckeye Health Medicaid OOS $3,872.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $13,102.71
Rate for Payer: Managed Health Services Medicaid $13,102.71
Rate for Payer: MDWise Medicaid $13,102.71
Rate for Payer: Molina Healthcare of OH Medicare $3,872.35
Service Code APR-DRG 7231
Hospital Charge Code APRDRG 7231
Min. Negotiated Rate $1,771.10
Max. Negotiated Rate $4,566.96
Rate for Payer: Buckeye Health Medicaid OOS $1,771.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $4,566.96
Rate for Payer: Managed Health Services Medicaid $4,566.96
Rate for Payer: MDWise Medicaid $4,566.96
Rate for Payer: Molina Healthcare of OH Medicare $1,771.10
Service Code APR-DRG 7232
Hospital Charge Code APRDRG 7232
Min. Negotiated Rate $2,286.97
Max. Negotiated Rate $6,573.56
Rate for Payer: Buckeye Health Medicaid OOS $2,286.97
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $6,573.56
Rate for Payer: Managed Health Services Medicaid $6,573.56
Rate for Payer: MDWise Medicaid $6,573.56
Rate for Payer: Molina Healthcare of OH Medicare $2,286.97
Service Code APR-DRG 7233
Hospital Charge Code APRDRG 7233
Min. Negotiated Rate $3,583.51
Max. Negotiated Rate $11,615.34
Rate for Payer: Buckeye Health Medicaid OOS $3,583.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $11,615.34
Rate for Payer: Managed Health Services Medicaid $11,615.34
Rate for Payer: MDWise Medicaid $11,615.34
Rate for Payer: Molina Healthcare of OH Medicare $3,583.51
Service Code APR-DRG 7234
Hospital Charge Code APRDRG 7234
Min. Negotiated Rate $6,471.52
Max. Negotiated Rate $21,918.43
Rate for Payer: Buckeye Health Medicaid OOS $6,471.52
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $21,918.43
Rate for Payer: Managed Health Services Medicaid $21,918.43
Rate for Payer: MDWise Medicaid $21,918.43
Rate for Payer: Molina Healthcare of OH Medicare $6,471.52
Service Code APR-DRG 7241
Hospital Charge Code APRDRG 7241
Min. Negotiated Rate $2,149.28
Max. Negotiated Rate $9,820.87
Rate for Payer: Buckeye Health Medicaid OOS $2,149.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $9,820.87
Rate for Payer: Managed Health Services Medicaid $9,820.87
Rate for Payer: MDWise Medicaid $9,820.87
Rate for Payer: Molina Healthcare of OH Medicare $2,149.28
Service Code APR-DRG 7242
Hospital Charge Code APRDRG 7242
Min. Negotiated Rate $2,904.98
Max. Negotiated Rate $11,066.51
Rate for Payer: Buckeye Health Medicaid OOS $2,904.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $11,066.51
Rate for Payer: Managed Health Services Medicaid $11,066.51
Rate for Payer: MDWise Medicaid $11,066.51
Rate for Payer: Molina Healthcare of OH Medicare $2,904.98
Service Code APR-DRG 7243
Hospital Charge Code APRDRG 7243
Min. Negotiated Rate $5,236.78
Max. Negotiated Rate $22,935.91
Rate for Payer: Buckeye Health Medicaid OOS $5,236.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $22,935.91
Rate for Payer: Managed Health Services Medicaid $22,935.91
Rate for Payer: MDWise Medicaid $22,935.91
Rate for Payer: Molina Healthcare of OH Medicare $5,236.78
Service Code APR-DRG 7244
Hospital Charge Code APRDRG 7244
Min. Negotiated Rate $13,072.42
Max. Negotiated Rate $28,966.81
Rate for Payer: Buckeye Health Medicaid OOS $13,072.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $28,966.81
Rate for Payer: Managed Health Services Medicaid $28,966.81
Rate for Payer: MDWise Medicaid $28,966.81
Rate for Payer: Molina Healthcare of OH Medicare $13,072.42
Service Code APR-DRG 7401
Hospital Charge Code APRDRG 7401
Min. Negotiated Rate $1,307.20
Max. Negotiated Rate $2,140.31
Rate for Payer: Buckeye Health Medicaid OOS $2,140.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $1,307.20
Rate for Payer: Managed Health Services Medicaid $1,307.20
Rate for Payer: MDWise Medicaid $1,307.20
Rate for Payer: Molina Healthcare of OH Medicare $2,140.31
Service Code APR-DRG 7402
Hospital Charge Code APRDRG 7402
Min. Negotiated Rate $1,307.20
Max. Negotiated Rate $4,083.05
Rate for Payer: Buckeye Health Medicaid OOS $4,083.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $1,307.20
Rate for Payer: Managed Health Services Medicaid $1,307.20
Rate for Payer: MDWise Medicaid $1,307.20
Rate for Payer: Molina Healthcare of OH Medicare $4,083.05
Service Code APR-DRG 7403
Hospital Charge Code APRDRG 7403
Min. Negotiated Rate $1,307.20
Max. Negotiated Rate $4,083.05
Rate for Payer: Buckeye Health Medicaid OOS $4,083.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $1,307.20
Rate for Payer: Managed Health Services Medicaid $1,307.20
Rate for Payer: MDWise Medicaid $1,307.20
Rate for Payer: Molina Healthcare of OH Medicare $4,083.05
Service Code APR-DRG 7404
Hospital Charge Code APRDRG 7404
Min. Negotiated Rate $1,307.20
Max. Negotiated Rate $4,083.05
Rate for Payer: Buckeye Health Medicaid OOS $4,083.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $1,307.20
Rate for Payer: Managed Health Services Medicaid $1,307.20
Rate for Payer: MDWise Medicaid $1,307.20
Rate for Payer: Molina Healthcare of OH Medicare $4,083.05