INPATIENT APRDRG 4412: MAJOR BLADDER PROCEDURES
|
Facility
|
IP
|
$13,364.52
|
|
Service Code
|
APR-DRG 4412
|
Hospital Charge Code |
APRDRG 4412
|
Min. Negotiated Rate |
$13,364.52 |
Max. Negotiated Rate |
$13,364.52 |
Rate for Payer: Aetna CHP/Medicaid |
$13,364.52
|
Rate for Payer: Humana OH Medicaid |
$13,364.52
|
|
INPATIENT APRDRG 4413: MAJOR BLADDER PROCEDURES
|
Facility
|
IP
|
$17,954.47
|
|
Service Code
|
APR-DRG 4413
|
Hospital Charge Code |
APRDRG 4413
|
Min. Negotiated Rate |
$17,954.47 |
Max. Negotiated Rate |
$17,954.47 |
Rate for Payer: Aetna CHP/Medicaid |
$17,954.47
|
Rate for Payer: Humana OH Medicaid |
$17,954.47
|
|
INPATIENT APRDRG 4414: MAJOR BLADDER PROCEDURES
|
Facility
|
IP
|
$27,661.19
|
|
Service Code
|
APR-DRG 4414
|
Hospital Charge Code |
APRDRG 4414
|
Min. Negotiated Rate |
$27,661.19 |
Max. Negotiated Rate |
$27,661.19 |
Rate for Payer: Aetna CHP/Medicaid |
$27,661.19
|
Rate for Payer: Humana OH Medicaid |
$27,661.19
|
|
INPATIENT APRDRG 4421: KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$8,023.65
|
|
Service Code
|
APR-DRG 4421
|
Hospital Charge Code |
APRDRG 4421
|
Min. Negotiated Rate |
$8,023.65 |
Max. Negotiated Rate |
$8,023.65 |
Rate for Payer: Aetna CHP/Medicaid |
$8,023.65
|
Rate for Payer: Humana OH Medicaid |
$8,023.65
|
|
INPATIENT APRDRG 4422: KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$9,205.24
|
|
Service Code
|
APR-DRG 4422
|
Hospital Charge Code |
APRDRG 4422
|
Min. Negotiated Rate |
$9,205.24 |
Max. Negotiated Rate |
$9,205.24 |
Rate for Payer: Aetna CHP/Medicaid |
$9,205.24
|
Rate for Payer: Humana OH Medicaid |
$9,205.24
|
|
INPATIENT APRDRG 4423: KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$14,301.87
|
|
Service Code
|
APR-DRG 4423
|
Hospital Charge Code |
APRDRG 4423
|
Min. Negotiated Rate |
$14,301.87 |
Max. Negotiated Rate |
$14,301.87 |
Rate for Payer: Aetna CHP/Medicaid |
$14,301.87
|
Rate for Payer: Humana OH Medicaid |
$14,301.87
|
|
INPATIENT APRDRG 4424: KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$21,942.26
|
|
Service Code
|
APR-DRG 4424
|
Hospital Charge Code |
APRDRG 4424
|
Min. Negotiated Rate |
$21,942.26 |
Max. Negotiated Rate |
$21,942.26 |
Rate for Payer: Aetna CHP/Medicaid |
$21,942.26
|
Rate for Payer: Humana OH Medicaid |
$21,942.26
|
|
INPATIENT APRDRG 4431: KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY
|
Facility
|
IP
|
$6,868.04
|
|
Service Code
|
APR-DRG 4431
|
Hospital Charge Code |
APRDRG 4431
|
Min. Negotiated Rate |
$6,868.04 |
Max. Negotiated Rate |
$6,868.04 |
Rate for Payer: Aetna CHP/Medicaid |
$6,868.04
|
Rate for Payer: Humana OH Medicaid |
$6,868.04
|
|
INPATIENT APRDRG 4432: KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY
|
Facility
|
IP
|
$7,621.56
|
|
Service Code
|
APR-DRG 4432
|
Hospital Charge Code |
APRDRG 4432
|
Min. Negotiated Rate |
$7,621.56 |
Max. Negotiated Rate |
$7,621.56 |
Rate for Payer: Aetna CHP/Medicaid |
$7,621.56
|
Rate for Payer: Humana OH Medicaid |
$7,621.56
|
|
INPATIENT APRDRG 4433: KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY
|
Facility
|
IP
|
$15,069.03
|
|
Service Code
|
APR-DRG 4433
|
Hospital Charge Code |
APRDRG 4433
|
Min. Negotiated Rate |
$15,069.03 |
Max. Negotiated Rate |
$15,069.03 |
Rate for Payer: Aetna CHP/Medicaid |
$15,069.03
|
Rate for Payer: Humana OH Medicaid |
$15,069.03
|
|
INPATIENT APRDRG 4434: KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY
|
Facility
|
IP
|
$15,069.03
|
|
Service Code
|
APR-DRG 4434
|
Hospital Charge Code |
APRDRG 4434
|
Min. Negotiated Rate |
$15,069.03 |
Max. Negotiated Rate |
$15,069.03 |
Rate for Payer: Aetna CHP/Medicaid |
$15,069.03
|
Rate for Payer: Humana OH Medicaid |
$15,069.03
|
|
INPATIENT APRDRG 4441: RENAL DIALYSIS ACCESS DEVICE AND VESSEL REPAIR
|
Facility
|
IP
|
$8,119.14
|
|
Service Code
|
APR-DRG 4441
|
Hospital Charge Code |
APRDRG 4441
|
Min. Negotiated Rate |
$8,119.14 |
Max. Negotiated Rate |
$8,119.14 |
Rate for Payer: Aetna CHP/Medicaid |
$8,119.14
|
Rate for Payer: Humana OH Medicaid |
$8,119.14
|
|
INPATIENT APRDRG 4442: RENAL DIALYSIS ACCESS DEVICE AND VESSEL REPAIR
|
Facility
|
IP
|
$8,119.14
|
|
Service Code
|
APR-DRG 4442
|
Hospital Charge Code |
APRDRG 4442
|
Min. Negotiated Rate |
$8,119.14 |
Max. Negotiated Rate |
$8,119.14 |
Rate for Payer: Aetna CHP/Medicaid |
$8,119.14
|
Rate for Payer: Humana OH Medicaid |
$8,119.14
|
|
INPATIENT APRDRG 4443: RENAL DIALYSIS ACCESS DEVICE AND VESSEL REPAIR
|
Facility
|
IP
|
$12,140.71
|
|
Service Code
|
APR-DRG 4443
|
Hospital Charge Code |
APRDRG 4443
|
Min. Negotiated Rate |
$12,140.71 |
Max. Negotiated Rate |
$12,140.71 |
Rate for Payer: Aetna CHP/Medicaid |
$12,140.71
|
Rate for Payer: Humana OH Medicaid |
$12,140.71
|
|
INPATIENT APRDRG 4444: RENAL DIALYSIS ACCESS DEVICE AND VESSEL REPAIR
|
Facility
|
IP
|
$21,306.97
|
|
Service Code
|
APR-DRG 4444
|
Hospital Charge Code |
APRDRG 4444
|
Min. Negotiated Rate |
$21,306.97 |
Max. Negotiated Rate |
$21,306.97 |
Rate for Payer: Aetna CHP/Medicaid |
$21,306.97
|
Rate for Payer: Humana OH Medicaid |
$21,306.97
|
|
INPATIENT APRDRG 4451: OTHER BLADDER PROCEDURES
|
Facility
|
IP
|
$5,591.61
|
|
Service Code
|
APR-DRG 4451
|
Hospital Charge Code |
APRDRG 4451
|
Min. Negotiated Rate |
$5,591.61 |
Max. Negotiated Rate |
$5,591.61 |
Rate for Payer: Aetna CHP/Medicaid |
$5,591.61
|
Rate for Payer: Humana OH Medicaid |
$5,591.61
|
|
INPATIENT APRDRG 4452: OTHER BLADDER PROCEDURES
|
Facility
|
IP
|
$9,934.07
|
|
Service Code
|
APR-DRG 4452
|
Hospital Charge Code |
APRDRG 4452
|
Min. Negotiated Rate |
$9,934.07 |
Max. Negotiated Rate |
$9,934.07 |
Rate for Payer: Aetna CHP/Medicaid |
$9,934.07
|
Rate for Payer: Humana OH Medicaid |
$9,934.07
|
|
INPATIENT APRDRG 4453: OTHER BLADDER PROCEDURES
|
Facility
|
IP
|
$12,097.83
|
|
Service Code
|
APR-DRG 4453
|
Hospital Charge Code |
APRDRG 4453
|
Min. Negotiated Rate |
$12,097.83 |
Max. Negotiated Rate |
$12,097.83 |
Rate for Payer: Aetna CHP/Medicaid |
$12,097.83
|
Rate for Payer: Humana OH Medicaid |
$12,097.83
|
|
INPATIENT APRDRG 4454: OTHER BLADDER PROCEDURES
|
Facility
|
IP
|
$12,097.83
|
|
Service Code
|
APR-DRG 4454
|
Hospital Charge Code |
APRDRG 4454
|
Min. Negotiated Rate |
$12,097.83 |
Max. Negotiated Rate |
$12,097.83 |
Rate for Payer: Aetna CHP/Medicaid |
$12,097.83
|
Rate for Payer: Humana OH Medicaid |
$12,097.83
|
|
INPATIENT APRDRG 4461: URETHRAL & TRANSURETHRAL PROCEDURES
|
Facility
|
IP
|
$4,059.89
|
|
Service Code
|
APR-DRG 4461
|
Hospital Charge Code |
APRDRG 4461
|
Min. Negotiated Rate |
$4,059.89 |
Max. Negotiated Rate |
$4,059.89 |
Rate for Payer: Aetna CHP/Medicaid |
$4,059.89
|
Rate for Payer: Humana OH Medicaid |
$4,059.89
|
|
INPATIENT APRDRG 4462: URETHRAL & TRANSURETHRAL PROCEDURES
|
Facility
|
IP
|
$5,175.88
|
|
Service Code
|
APR-DRG 4462
|
Hospital Charge Code |
APRDRG 4462
|
Min. Negotiated Rate |
$5,175.88 |
Max. Negotiated Rate |
$5,175.88 |
Rate for Payer: Aetna CHP/Medicaid |
$5,175.88
|
Rate for Payer: Humana OH Medicaid |
$5,175.88
|
|
INPATIENT APRDRG 4463: URETHRAL & TRANSURETHRAL PROCEDURES
|
Facility
|
IP
|
$9,601.49
|
|
Service Code
|
APR-DRG 4463
|
Hospital Charge Code |
APRDRG 4463
|
Min. Negotiated Rate |
$9,601.49 |
Max. Negotiated Rate |
$9,601.49 |
Rate for Payer: Aetna CHP/Medicaid |
$9,601.49
|
Rate for Payer: Humana OH Medicaid |
$9,601.49
|
|
INPATIENT APRDRG 4464: URETHRAL & TRANSURETHRAL PROCEDURES
|
Facility
|
IP
|
$15,115.80
|
|
Service Code
|
APR-DRG 4464
|
Hospital Charge Code |
APRDRG 4464
|
Min. Negotiated Rate |
$15,115.80 |
Max. Negotiated Rate |
$15,115.80 |
Rate for Payer: Aetna CHP/Medicaid |
$15,115.80
|
Rate for Payer: Humana OH Medicaid |
$15,115.80
|
|
INPATIENT APRDRG 4471: OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES
|
Facility
|
IP
|
$8,301.67
|
|
Service Code
|
APR-DRG 4471
|
Hospital Charge Code |
APRDRG 4471
|
Min. Negotiated Rate |
$8,301.67 |
Max. Negotiated Rate |
$8,301.67 |
Rate for Payer: Aetna CHP/Medicaid |
$8,301.67
|
Rate for Payer: Humana OH Medicaid |
$8,301.67
|
|
INPATIENT APRDRG 4472: OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES
|
Facility
|
IP
|
$8,301.67
|
|
Service Code
|
APR-DRG 4472
|
Hospital Charge Code |
APRDRG 4472
|
Min. Negotiated Rate |
$8,301.67 |
Max. Negotiated Rate |
$8,301.67 |
Rate for Payer: Aetna CHP/Medicaid |
$8,301.67
|
Rate for Payer: Humana OH Medicaid |
$8,301.67
|
|