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Charge Type Price  
Service Code APR-DRG 8161
Hospital Charge Code APRDRG 8161
Min. Negotiated Rate $1,374.36
Max. Negotiated Rate $6,621.65
Rate for Payer: Buckeye Health Medicaid OOS $1,374.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $6,621.65
Rate for Payer: Managed Health Services Medicaid $6,621.65
Rate for Payer: MDWise Medicaid $6,621.65
Rate for Payer: Molina Healthcare of OH Medicare $1,374.36
Service Code APR-DRG 8162
Hospital Charge Code APRDRG 8162
Min. Negotiated Rate $1,692.01
Max. Negotiated Rate $8,471.62
Rate for Payer: Buckeye Health Medicaid OOS $1,692.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $8,471.62
Rate for Payer: Managed Health Services Medicaid $8,471.62
Rate for Payer: MDWise Medicaid $8,471.62
Rate for Payer: Molina Healthcare of OH Medicare $1,692.01
Service Code APR-DRG 8163
Hospital Charge Code APRDRG 8163
Min. Negotiated Rate $2,163.37
Max. Negotiated Rate $10,016.96
Rate for Payer: Buckeye Health Medicaid OOS $2,163.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $10,016.96
Rate for Payer: Managed Health Services Medicaid $10,016.96
Rate for Payer: MDWise Medicaid $10,016.96
Rate for Payer: Molina Healthcare of OH Medicare $2,163.37
Service Code APR-DRG 8164
Hospital Charge Code APRDRG 8164
Min. Negotiated Rate $4,349.47
Max. Negotiated Rate $22,031.89
Rate for Payer: Buckeye Health Medicaid OOS $4,349.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $22,031.89
Rate for Payer: Managed Health Services Medicaid $22,031.89
Rate for Payer: MDWise Medicaid $22,031.89
Rate for Payer: Molina Healthcare of OH Medicare $4,349.47
Service Code APR-DRG 8171
Hospital Charge Code APRDRG 8171
Min. Negotiated Rate $1,369.56
Max. Negotiated Rate $6,542.72
Rate for Payer: Buckeye Health Medicaid OOS $1,369.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $6,542.72
Rate for Payer: Managed Health Services Medicaid $6,542.72
Rate for Payer: MDWise Medicaid $6,542.72
Rate for Payer: Molina Healthcare of OH Medicare $1,369.56
Service Code APR-DRG 8172
Hospital Charge Code APRDRG 8172
Min. Negotiated Rate $1,670.24
Max. Negotiated Rate $8,070.80
Rate for Payer: Buckeye Health Medicaid OOS $1,670.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $8,070.80
Rate for Payer: Managed Health Services Medicaid $8,070.80
Rate for Payer: MDWise Medicaid $8,070.80
Rate for Payer: Molina Healthcare of OH Medicare $1,670.24
Service Code APR-DRG 8173
Hospital Charge Code APRDRG 8173
Min. Negotiated Rate $2,283.45
Max. Negotiated Rate $9,194.34
Rate for Payer: Buckeye Health Medicaid OOS $2,283.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $9,194.34
Rate for Payer: Managed Health Services Medicaid $9,194.34
Rate for Payer: MDWise Medicaid $9,194.34
Rate for Payer: Molina Healthcare of OH Medicare $2,283.45
Service Code APR-DRG 8174
Hospital Charge Code APRDRG 8174
Min. Negotiated Rate $5,060.98
Max. Negotiated Rate $21,040.31
Rate for Payer: Buckeye Health Medicaid OOS $5,060.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $21,040.31
Rate for Payer: Managed Health Services Medicaid $21,040.31
Rate for Payer: MDWise Medicaid $21,040.31
Rate for Payer: Molina Healthcare of OH Medicare $5,060.98
Service Code APR-DRG 8411
Hospital Charge Code APRDRG 8411
Min. Negotiated Rate $855.00
Max. Negotiated Rate $36,549.55
Rate for Payer: Buckeye Health Medicaid OOS $36,549.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $36,549.55
Service Code APR-DRG 8412
Hospital Charge Code APRDRG 8412
Min. Negotiated Rate $855.00
Max. Negotiated Rate $36,549.55
Rate for Payer: Buckeye Health Medicaid OOS $36,549.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $36,549.55
Service Code APR-DRG 8413
Hospital Charge Code APRDRG 8413
Min. Negotiated Rate $855.00
Max. Negotiated Rate $36,549.55
Rate for Payer: Buckeye Health Medicaid OOS $36,549.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $36,549.55
Service Code APR-DRG 8414
Hospital Charge Code APRDRG 8414
Min. Negotiated Rate $855.00
Max. Negotiated Rate $36,549.55
Rate for Payer: Buckeye Health Medicaid OOS $36,549.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $36,549.55
Service Code APR-DRG 8421
Hospital Charge Code APRDRG 8421
Min. Negotiated Rate $855.00
Max. Negotiated Rate $7,846.84
Rate for Payer: Buckeye Health Medicaid OOS $7,846.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $7,846.84
Service Code APR-DRG 8422
Hospital Charge Code APRDRG 8422
Min. Negotiated Rate $855.00
Max. Negotiated Rate $10,672.41
Rate for Payer: Buckeye Health Medicaid OOS $10,672.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $10,672.41
Service Code APR-DRG 8423
Hospital Charge Code APRDRG 8423
Min. Negotiated Rate $855.00
Max. Negotiated Rate $21,566.41
Rate for Payer: Buckeye Health Medicaid OOS $21,566.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $21,566.41
Service Code APR-DRG 8424
Hospital Charge Code APRDRG 8424
Min. Negotiated Rate $855.00
Max. Negotiated Rate $24,142.53
Rate for Payer: Buckeye Health Medicaid OOS $24,142.53
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $24,142.53
Service Code APR-DRG 8431
Hospital Charge Code APRDRG 8431
Min. Negotiated Rate $855.00
Max. Negotiated Rate $2,361.58
Rate for Payer: Buckeye Health Medicaid OOS $2,361.58
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $2,361.58
Service Code APR-DRG 8432
Hospital Charge Code APRDRG 8432
Min. Negotiated Rate $855.00
Max. Negotiated Rate $3,547.65
Rate for Payer: Buckeye Health Medicaid OOS $3,547.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $3,547.65
Service Code APR-DRG 8433
Hospital Charge Code APRDRG 8433
Min. Negotiated Rate $855.00
Max. Negotiated Rate $7,345.39
Rate for Payer: Buckeye Health Medicaid OOS $7,345.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $7,345.39
Service Code APR-DRG 8434
Hospital Charge Code APRDRG 8434
Min. Negotiated Rate $855.00
Max. Negotiated Rate $7,345.39
Rate for Payer: Buckeye Health Medicaid OOS $7,345.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $7,345.39
Service Code APR-DRG 8441
Hospital Charge Code APRDRG 8441
Min. Negotiated Rate $855.00
Max. Negotiated Rate $1,994.61
Rate for Payer: Buckeye Health Medicaid OOS $1,994.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $1,994.61
Service Code APR-DRG 8442
Hospital Charge Code APRDRG 8442
Min. Negotiated Rate $855.00
Max. Negotiated Rate $3,039.79
Rate for Payer: Buckeye Health Medicaid OOS $3,039.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $3,039.79
Service Code APR-DRG 8443
Hospital Charge Code APRDRG 8443
Min. Negotiated Rate $855.00
Max. Negotiated Rate $7,166.07
Rate for Payer: Buckeye Health Medicaid OOS $7,166.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $7,166.07
Service Code APR-DRG 8444
Hospital Charge Code APRDRG 8444
Min. Negotiated Rate $855.00
Max. Negotiated Rate $7,166.07
Rate for Payer: Buckeye Health Medicaid OOS $7,166.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $855.00
Rate for Payer: Managed Health Services Medicaid $855.00
Rate for Payer: MDWise Medicaid $855.00
Rate for Payer: Molina Healthcare of OH Medicare $7,166.07
Service Code APR-DRG 8501
Hospital Charge Code APRDRG 8501
Min. Negotiated Rate $6,370.02
Max. Negotiated Rate $24,661.32
Rate for Payer: Buckeye Health Medicaid OOS $6,370.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $24,661.32
Rate for Payer: Managed Health Services Medicaid $24,661.32
Rate for Payer: MDWise Medicaid $24,661.32
Rate for Payer: Molina Healthcare of OH Medicare $6,370.02