|
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
|
$36,315.91
|
|
|
Service Code
|
APR-DRG 6253
|
| Min. Negotiated Rate |
$27,709.08 |
| Max. Negotiated Rate |
$36,315.91 |
| Rate for Payer: Aetna Better Health Medicaid |
$35,603.83
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$36,315.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27,709.08
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$29,348.75
|
|
|
Service Code
|
APR-DRG 6222
|
| Min. Negotiated Rate |
$22,326.56 |
| Max. Negotiated Rate |
$29,348.75 |
| Rate for Payer: Aetna Better Health Medicaid |
$28,773.28
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$29,348.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22,326.56
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$32,915.90
|
|
|
Service Code
|
APR-DRG 6223
|
| Min. Negotiated Rate |
$32,270.49 |
| Max. Negotiated Rate |
$32,915.90 |
| Rate for Payer: Aetna Better Health Medicaid |
$32,270.49
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$32,915.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32,551.00
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$54,741.38
|
|
|
Service Code
|
APR-DRG 6224
|
| Min. Negotiated Rate |
$52,067.41 |
| Max. Negotiated Rate |
$54,741.38 |
| Rate for Payer: Aetna Better Health Medicaid |
$53,668.02
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$54,741.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$52,067.41
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$19,546.18
|
|
|
Service Code
|
APR-DRG 6221
|
| Min. Negotiated Rate |
$15,062.66 |
| Max. Negotiated Rate |
$19,546.18 |
| Rate for Payer: Aetna Better Health Medicaid |
$19,162.92
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$19,546.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15,062.66
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,464.80
|
|
|
Service Code
|
APR-DRG 6401
|
| Min. Negotiated Rate |
$1,002.88 |
| Max. Negotiated Rate |
$1,464.80 |
| Rate for Payer: Aetna Better Health Medicaid |
$1,436.08
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,464.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,002.88
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$26,962.71
|
|
|
Service Code
|
APR-DRG 6404
|
| Min. Negotiated Rate |
$17,574.61 |
| Max. Negotiated Rate |
$26,962.71 |
| Rate for Payer: Aetna Better Health Medicaid |
$26,434.03
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$26,962.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17,574.61
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$3,606.42
|
|
|
Service Code
|
APR-DRG 6403
|
| Min. Negotiated Rate |
$3,420.06 |
| Max. Negotiated Rate |
$3,606.42 |
| Rate for Payer: Aetna Better Health Medicaid |
$3,420.06
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$3,488.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3,606.42
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,939.43
|
|
|
Service Code
|
APR-DRG 6402
|
| Min. Negotiated Rate |
$1,483.42 |
| Max. Negotiated Rate |
$1,939.43 |
| Rate for Payer: Aetna Better Health Medicaid |
$1,901.40
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,939.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,483.42
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$26,815.22
|
|
|
Service Code
|
APR-DRG 6363
|
| Min. Negotiated Rate |
$19,238.67 |
| Max. Negotiated Rate |
$26,815.22 |
| Rate for Payer: Aetna Better Health Medicaid |
$26,289.43
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$26,815.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19,238.67
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$12,035.51
|
|
|
Service Code
|
APR-DRG 6362
|
| Min. Negotiated Rate |
$10,218.45 |
| Max. Negotiated Rate |
$12,035.51 |
| Rate for Payer: Aetna Better Health Medicaid |
$11,799.52
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$12,035.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10,218.45
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$40,134.42
|
|
|
Service Code
|
APR-DRG 6364
|
| Min. Negotiated Rate |
$39,347.47 |
| Max. Negotiated Rate |
$40,134.42 |
| Rate for Payer: Aetna Better Health Medicaid |
$39,347.47
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$40,134.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40,098.51
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$6,896.91
|
|
|
Service Code
|
APR-DRG 6361
|
| Min. Negotiated Rate |
$6,761.68 |
| Max. Negotiated Rate |
$6,896.91 |
| Rate for Payer: Aetna Better Health Medicaid |
$6,761.68
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$6,896.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6,850.57
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$2,651.15
|
|
|
Service Code
|
APR-DRG 6331
|
| Min. Negotiated Rate |
$2,395.70 |
| Max. Negotiated Rate |
$2,651.15 |
| Rate for Payer: Aetna Better Health Medicaid |
$2,395.70
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,443.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,651.15
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$74,742.61
|
|
|
Service Code
|
APR-DRG 6334
|
| Min. Negotiated Rate |
$48,128.19 |
| Max. Negotiated Rate |
$74,742.61 |
| Rate for Payer: Aetna Better Health Medicaid |
$73,277.07
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$74,742.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$48,128.19
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$26,127.08
|
|
|
Service Code
|
APR-DRG 6333
|
| Min. Negotiated Rate |
$16,025.43 |
| Max. Negotiated Rate |
$26,127.08 |
| Rate for Payer: Aetna Better Health Medicaid |
$25,614.78
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$26,127.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16,025.43
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$7,545.94
|
|
|
Service Code
|
APR-DRG 6332
|
| Min. Negotiated Rate |
$7,006.76 |
| Max. Negotiated Rate |
$7,545.94 |
| Rate for Payer: Aetna Better Health Medicaid |
$7,006.76
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,146.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,545.94
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$65,316.39
|
|
|
Service Code
|
APR-DRG 6302
|
| Min. Negotiated Rate |
$29,392.20 |
| Max. Negotiated Rate |
$65,316.39 |
| Rate for Payer: Aetna Better Health Medicaid |
$64,035.68
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$65,316.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29,392.20
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$133,875.41
|
|
|
Service Code
|
APR-DRG 6303
|
| Min. Negotiated Rate |
$46,249.66 |
| Max. Negotiated Rate |
$133,875.41 |
| Rate for Payer: Aetna Better Health Medicaid |
$131,250.40
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$133,875.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46,249.66
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$247,140.23
|
|
|
Service Code
|
APR-DRG 6304
|
| Min. Negotiated Rate |
$106,061.94 |
| Max. Negotiated Rate |
$247,140.23 |
| Rate for Payer: Aetna Better Health Medicaid |
$242,294.34
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$247,140.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$106,061.94
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
|
IP
|
$30,055.16
|
|
|
Service Code
|
APR-DRG 6301
|
| Min. Negotiated Rate |
$21,620.06 |
| Max. Negotiated Rate |
$30,055.16 |
| Rate for Payer: Aetna Better Health Medicaid |
$29,465.84
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$30,055.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21,620.06
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$12,139.02
|
|
|
Service Code
|
APR-DRG 6311
|
| Min. Negotiated Rate |
$5,636.77 |
| Max. Negotiated Rate |
$12,139.02 |
| Rate for Payer: Aetna Better Health Medicaid |
$5,636.77
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$5,749.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12,139.02
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$44,483.77
|
|
|
Service Code
|
APR-DRG 6312
|
| Min. Negotiated Rate |
$15,036.16 |
| Max. Negotiated Rate |
$44,483.77 |
| Rate for Payer: Aetna Better Health Medicaid |
$43,611.54
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$44,483.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15,036.16
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
|
IP
|
$232,478.45
|
|
|
Service Code
|
APR-DRG 6314
|
| Min. Negotiated Rate |
$94,158.61 |
| Max. Negotiated Rate |
$232,478.45 |
| Rate for Payer: Aetna Better Health Medicaid |
$227,920.05
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$232,478.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$94,158.61
|
|