|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$61,472.54
|
|
|
Service Code
|
APR-DRG 6123
|
| Min. Negotiated Rate |
$51,054.43 |
| Max. Negotiated Rate |
$61,472.54 |
| Rate for Payer: Aetna Better Health Medicaid |
$60,267.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$61,472.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$51,054.43
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$48,170.31
|
|
|
Service Code
|
APR-DRG 6122
|
| Min. Negotiated Rate |
$36,921.08 |
| Max. Negotiated Rate |
$48,170.31 |
| Rate for Payer: Aetna Better Health Medicaid |
$47,225.79
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$48,170.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36,921.08
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$31,233.43
|
|
|
Service Code
|
APR-DRG 6121
|
| Min. Negotiated Rate |
$24,221.06 |
| Max. Negotiated Rate |
$31,233.43 |
| Rate for Payer: Aetna Better Health Medicaid |
$30,621.01
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$31,233.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24,221.06
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$56,956.06
|
|
|
Service Code
|
APR-DRG 6092
|
| Min. Negotiated Rate |
$46,706.12 |
| Max. Negotiated Rate |
$56,956.06 |
| Rate for Payer: Aetna Better Health Medicaid |
$55,839.27
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$56,956.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46,706.12
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$51,665.75
|
|
|
Service Code
|
APR-DRG 6091
|
| Min. Negotiated Rate |
$35,962.07 |
| Max. Negotiated Rate |
$51,665.75 |
| Rate for Payer: Aetna Better Health Medicaid |
$50,652.70
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$51,665.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35,962.07
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$229,819.93
|
|
|
Service Code
|
APR-DRG 6094
|
| Min. Negotiated Rate |
$138,168.33 |
| Max. Negotiated Rate |
$229,819.93 |
| Rate for Payer: Aetna Better Health Medicaid |
$225,313.66
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$229,819.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$138,168.33
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$100,240.51
|
|
|
Service Code
|
APR-DRG 6093
|
| Min. Negotiated Rate |
$74,512.43 |
| Max. Negotiated Rate |
$100,240.51 |
| Rate for Payer: Aetna Better Health Medicaid |
$98,275.01
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$100,240.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$74,512.43
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$227,002.81
|
|
|
Service Code
|
APR-DRG 5882
|
| Min. Negotiated Rate |
$87,176.39 |
| Max. Negotiated Rate |
$227,002.81 |
| Rate for Payer: Aetna Better Health Medicaid |
$222,551.77
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$227,002.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$87,176.39
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$150,982.18
|
|
|
Service Code
|
APR-DRG 5881
|
| Min. Negotiated Rate |
$78,458.72 |
| Max. Negotiated Rate |
$150,982.18 |
| Rate for Payer: Aetna Better Health Medicaid |
$148,021.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$150,982.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$78,458.72
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$363,602.76
|
|
|
Service Code
|
APR-DRG 5884
|
| Min. Negotiated Rate |
$238,257.22 |
| Max. Negotiated Rate |
$363,602.76 |
| Rate for Payer: Aetna Better Health Medicaid |
$356,473.29
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$363,602.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$238,257.22
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$233,204.52
|
|
|
Service Code
|
APR-DRG 5883
|
| Min. Negotiated Rate |
$178,005.97 |
| Max. Negotiated Rate |
$233,204.52 |
| Rate for Payer: Aetna Better Health Medicaid |
$228,631.88
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$233,204.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$178,005.97
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$2,092.52
|
|
|
Service Code
|
APR-DRG 6261
|
| Min. Negotiated Rate |
$1,412.15 |
| Max. Negotiated Rate |
$2,092.52 |
| Rate for Payer: Aetna Better Health Medicaid |
$2,051.49
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,092.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,412.15
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$3,493.17
|
|
|
Service Code
|
APR-DRG 6262
|
| Min. Negotiated Rate |
$2,332.40 |
| Max. Negotiated Rate |
$3,493.17 |
| Rate for Payer: Aetna Better Health Medicaid |
$2,332.40
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,379.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3,493.17
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$10,195.70
|
|
|
Service Code
|
APR-DRG 6263
|
| Min. Negotiated Rate |
$5,474.33 |
| Max. Negotiated Rate |
$10,195.70 |
| Rate for Payer: Aetna Better Health Medicaid |
$5,474.33
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$5,583.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10,195.70
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$31,036.80
|
|
|
Service Code
|
APR-DRG 6264
|
| Min. Negotiated Rate |
$22,942.79 |
| Max. Negotiated Rate |
$31,036.80 |
| Rate for Payer: Aetna Better Health Medicaid |
$30,428.24
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$31,036.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22,942.79
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$52,390.43
|
|
|
Service Code
|
APR-DRG 6234
|
| Min. Negotiated Rate |
$51,363.17 |
| Max. Negotiated Rate |
$52,390.43 |
| Rate for Payer: Aetna Better Health Medicaid |
$51,363.17
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$52,390.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$51,368.96
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$12,104.38
|
|
|
Service Code
|
APR-DRG 6231
|
| Min. Negotiated Rate |
$11,867.04 |
| Max. Negotiated Rate |
$12,104.38 |
| Rate for Payer: Aetna Better Health Medicaid |
$11,867.04
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$12,104.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11,939.99
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$20,768.49
|
|
|
Service Code
|
APR-DRG 6232
|
| Min. Negotiated Rate |
$19,319.85 |
| Max. Negotiated Rate |
$20,768.49 |
| Rate for Payer: Aetna Better Health Medicaid |
$19,319.85
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$19,706.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20,768.49
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$44,271.71
|
|
|
Service Code
|
APR-DRG 6233
|
| Min. Negotiated Rate |
$33,775.96 |
| Max. Negotiated Rate |
$44,271.71 |
| Rate for Payer: Aetna Better Health Medicaid |
$43,403.64
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$44,271.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33,775.96
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$20,161.81
|
|
|
Service Code
|
APR-DRG 6212
|
| Min. Negotiated Rate |
$17,110.07 |
| Max. Negotiated Rate |
$20,161.81 |
| Rate for Payer: Aetna Better Health Medicaid |
$17,110.07
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$17,452.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20,161.81
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$9,316.12
|
|
|
Service Code
|
APR-DRG 6211
|
| Min. Negotiated Rate |
$4,898.82 |
| Max. Negotiated Rate |
$9,316.12 |
| Rate for Payer: Aetna Better Health Medicaid |
$4,898.82
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$4,996.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,316.12
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$38,668.24
|
|
|
Service Code
|
APR-DRG 6213
|
| Min. Negotiated Rate |
$33,958.37 |
| Max. Negotiated Rate |
$38,668.24 |
| Rate for Payer: Aetna Better Health Medicaid |
$37,910.04
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$38,668.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33,958.37
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$79,426.16
|
|
|
Service Code
|
APR-DRG 6214
|
| Min. Negotiated Rate |
$67,144.96 |
| Max. Negotiated Rate |
$79,426.16 |
| Rate for Payer: Aetna Better Health Medicaid |
$77,868.78
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$79,426.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$67,144.96
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$22,199.39
|
|
|
Service Code
|
APR-DRG 6252
|
| Min. Negotiated Rate |
$17,575.39 |
| Max. Negotiated Rate |
$22,199.39 |
| Rate for Payer: Aetna Better Health Medicaid |
$17,575.39
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$17,926.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22,199.39
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$52,620.76
|
|
|
Service Code
|
APR-DRG 6254
|
| Min. Negotiated Rate |
$40,954.98 |
| Max. Negotiated Rate |
$52,620.76 |
| Rate for Payer: Aetna Better Health Medicaid |
$51,588.98
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$52,620.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40,954.98
|
|