|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$92,399.84
|
|
|
Service Code
|
MSDRG 469
|
| Min. Negotiated Rate |
$23,735.61 |
| Max. Negotiated Rate |
$92,399.84 |
| Rate for Payer: Aetna Managed Medicare |
$23,735.61
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$66,182.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$50,727.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$48,194.88
|
| Rate for Payer: Anthem Medicare Advantage |
$23,735.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23,735.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23,735.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23,735.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$53,500.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23,735.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$67,528.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23,735.61
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23,735.61
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23,735.61
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23,735.61
|
| Rate for Payer: NAPHCARE Commercial |
$35,603.41
|
| Rate for Payer: Quartz Medicare Advantage |
$23,735.61
|
| Rate for Payer: The Alliance Commercial |
$92,399.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,735.61
|
| Rate for Payer: United Healthcare PPO |
$52,571.68
|
| Rate for Payer: Wellcare Medicare |
$23,735.61
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$52,360.88
|
|
|
Service Code
|
MSDRG 470
|
| Min. Negotiated Rate |
$15,278.68 |
| Max. Negotiated Rate |
$52,360.88 |
| Rate for Payer: Aetna Managed Medicare |
$15,278.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$42,087.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32,259.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30,648.52
|
| Rate for Payer: Anthem Medicare Advantage |
$15,278.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,278.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,278.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,278.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34,022.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,278.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$38,160.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,278.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,278.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,278.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,278.68
|
| Rate for Payer: NAPHCARE Commercial |
$22,918.02
|
| Rate for Payer: Quartz Medicare Advantage |
$15,278.68
|
| Rate for Payer: The Alliance Commercial |
$52,360.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,278.68
|
| Rate for Payer: United Healthcare PPO |
$29,708.73
|
| Rate for Payer: Wellcare Medicare |
$15,278.68
|
|
|
Major Joint 20610 - Admin Intra-articular Injection Charge
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
3475534
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$305.51 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$572.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$547.37
|
| Rate for Payer: Aetna Managed Medicare |
$323.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$413.71
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$318.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$305.51
|
| Rate for Payer: Anthem Medicare Advantage |
$323.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$337.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$323.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$323.03
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cigna Commercial |
$585.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$323.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$323.03
|
| Rate for Payer: Health EOS Commercial |
$566.47
|
| Rate for Payer: HFN Commercial |
$585.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,201.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$323.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$323.03
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$323.03
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$323.03
|
| Rate for Payer: Multiplan Commercial |
$509.18
|
| Rate for Payer: NAPHCARE Commercial |
$484.55
|
| Rate for Payer: Preferred Network Access Commercial |
$585.56
|
| Rate for Payer: Quartz Beloit One Network |
$311.88
|
| Rate for Payer: Quartz Commercial |
$413.71
|
| Rate for Payer: Quartz Medicare Advantage |
$323.03
|
| Rate for Payer: The Alliance Commercial |
$1,292.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$323.03
|
| Rate for Payer: WEA Trust Commercial |
$350.06
|
| Rate for Payer: Wellcare Medicare |
$323.03
|
| Rate for Payer: WPS Commercial |
$471.42
|
|
|
Major Joint 20610 - Admin Intra-articular Injection Charge
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
3475534
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$311.88 |
| Max. Negotiated Rate |
$585.56 |
| Rate for Payer: Aetna Commercial |
$572.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$547.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$337.33
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cigna Commercial |
$585.56
|
| Rate for Payer: Health EOS Commercial |
$566.47
|
| Rate for Payer: HFN Commercial |
$585.56
|
| Rate for Payer: Multiplan Commercial |
$509.18
|
| Rate for Payer: Preferred Network Access Commercial |
$585.56
|
| Rate for Payer: Quartz Beloit One Network |
$311.88
|
| Rate for Payer: Quartz Commercial |
$381.89
|
| Rate for Payer: WEA Trust Commercial |
$350.06
|
| Rate for Payer: WPS Commercial |
$471.42
|
|
|
Major Joint 20610 - Admin Intra-articular Injection Charge
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
3475534
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$217.36 |
| Rate for Payer: Aetna Commercial |
$217.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$196.77
|
| Rate for Payer: Aetna Managed Medicare |
$37.79
|
| Rate for Payer: Anthem Medicare Advantage |
$37.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$37.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$37.79
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cigna Commercial |
$217.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$67.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$37.79
|
| Rate for Payer: Health EOS Commercial |
$208.21
|
| Rate for Payer: HFN Commercial |
$217.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$156.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$156.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$37.79
|
| Rate for Payer: Multiplan Commercial |
$183.04
|
| Rate for Payer: NAPHCARE Commercial |
$56.69
|
| Rate for Payer: Preferred Network Access Commercial |
$217.36
|
| Rate for Payer: Quartz Beloit One Network |
$100.67
|
| Rate for Payer: Quartz Commercial |
$130.42
|
| Rate for Payer: Quartz Medicare Advantage |
$37.79
|
| Rate for Payer: The Alliance Commercial |
$160.62
|
| Rate for Payer: United Healthcare Medicaid |
$67.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37.79
|
| Rate for Payer: WEA Trust Commercial |
$125.84
|
| Rate for Payer: WPS Commercial |
$170.07
|
|
|
Major joint or bursa w/ultrasound guidance 20611
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
4494833
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.32 |
| Max. Negotiated Rate |
$1,173.74 |
| Rate for Payer: Aetna Commercial |
$1,173.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,062.55
|
| Rate for Payer: Aetna Managed Medicare |
$48.32
|
| Rate for Payer: Anthem Medicare Advantage |
$48.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$48.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$48.32
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cigna Commercial |
$1,173.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$72.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.32
|
| Rate for Payer: Health EOS Commercial |
$1,124.32
|
| Rate for Payer: HFN Commercial |
$1,173.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$208.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$208.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$48.32
|
| Rate for Payer: Multiplan Commercial |
$988.42
|
| Rate for Payer: NAPHCARE Commercial |
$72.48
|
| Rate for Payer: Preferred Network Access Commercial |
$1,173.74
|
| Rate for Payer: Quartz Beloit One Network |
$543.63
|
| Rate for Payer: Quartz Commercial |
$704.25
|
| Rate for Payer: Quartz Medicare Advantage |
$48.32
|
| Rate for Payer: The Alliance Commercial |
$205.35
|
| Rate for Payer: United Healthcare Medicaid |
$72.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.32
|
| Rate for Payer: WEA Trust Commercial |
$679.54
|
| Rate for Payer: WPS Commercial |
$217.43
|
|
|
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$69,019.60
|
|
|
Service Code
|
MSDRG 483
|
| Min. Negotiated Rate |
$21,734.52 |
| Max. Negotiated Rate |
$69,019.60 |
| Rate for Payer: Aetna Managed Medicare |
$21,734.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$60,480.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$46,357.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$44,043.05
|
| Rate for Payer: Anthem Medicare Advantage |
$21,734.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21,734.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21,734.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$21,734.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48,891.83
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$21,734.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50,379.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21,734.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21,734.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$21,734.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$21,734.52
|
| Rate for Payer: NAPHCARE Commercial |
$32,601.78
|
| Rate for Payer: Quartz Medicare Advantage |
$21,734.52
|
| Rate for Payer: The Alliance Commercial |
$69,019.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,734.52
|
| Rate for Payer: United Healthcare PPO |
$39,221.15
|
| Rate for Payer: Wellcare Medicare |
$21,734.52
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$16,747.47
|
|
|
Service Code
|
APR-DRG 2312
|
| Min. Negotiated Rate |
$14,876.15 |
| Max. Negotiated Rate |
$16,747.47 |
| Rate for Payer: Anthem Medicaid |
$16,036.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$16,036.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16,036.63
|
| Rate for Payer: Dean Health Medicaid |
$16,036.63
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14,876.15
|
| Rate for Payer: Managed Health Services Medicaid |
$16,747.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,036.63
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16,036.63
|
| Rate for Payer: United Healthcare Medicaid |
$16,036.63
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$13,064.78
|
|
|
Service Code
|
APR-DRG 2311
|
| Min. Negotiated Rate |
$11,604.95 |
| Max. Negotiated Rate |
$13,064.78 |
| Rate for Payer: Anthem Medicaid |
$12,510.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,510.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,510.25
|
| Rate for Payer: Dean Health Medicaid |
$12,510.25
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,604.95
|
| Rate for Payer: Managed Health Services Medicaid |
$13,064.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,510.25
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,510.25
|
| Rate for Payer: United Healthcare Medicaid |
$12,510.25
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$35,687.02
|
|
|
Service Code
|
APR-DRG 2314
|
| Min. Negotiated Rate |
$31,699.44 |
| Max. Negotiated Rate |
$35,687.02 |
| Rate for Payer: Anthem Medicaid |
$34,172.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$34,172.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$34,172.29
|
| Rate for Payer: Dean Health Medicaid |
$34,172.29
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$31,699.44
|
| Rate for Payer: Managed Health Services Medicaid |
$35,687.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$34,172.29
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$34,172.29
|
| Rate for Payer: United Healthcare Medicaid |
$34,172.29
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$24,025.17
|
|
|
Service Code
|
APR-DRG 2313
|
| Min. Negotiated Rate |
$21,340.65 |
| Max. Negotiated Rate |
$24,025.17 |
| Rate for Payer: Anthem Medicaid |
$23,005.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$23,005.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$23,005.42
|
| Rate for Payer: Dean Health Medicaid |
$23,005.42
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$21,340.65
|
| Rate for Payer: Managed Health Services Medicaid |
$24,025.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$23,005.42
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$23,005.42
|
| Rate for Payer: United Healthcare Medicaid |
$23,005.42
|
|
|
MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$54,578.16
|
|
|
Service Code
|
MSDRG 707
|
| Min. Negotiated Rate |
$15,825.47 |
| Max. Negotiated Rate |
$54,578.16 |
| Rate for Payer: Aetna Managed Medicare |
$15,825.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$43,644.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$33,453.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$31,783.01
|
| Rate for Payer: Anthem Medicare Advantage |
$15,825.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,825.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,825.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,825.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35,282.05
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,825.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39,787.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,825.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,825.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,825.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,825.47
|
| Rate for Payer: NAPHCARE Commercial |
$23,738.21
|
| Rate for Payer: Quartz Medicare Advantage |
$15,825.47
|
| Rate for Payer: The Alliance Commercial |
$54,578.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,825.47
|
| Rate for Payer: United Healthcare PPO |
$30,974.94
|
| Rate for Payer: Wellcare Medicare |
$15,825.47
|
|
|
MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,659.84
|
|
|
Service Code
|
MSDRG 708
|
| Min. Negotiated Rate |
$12,255.98 |
| Max. Negotiated Rate |
$40,659.84 |
| Rate for Payer: Aetna Managed Medicare |
$12,255.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33,475.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25,658.33
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,377.09
|
| Rate for Payer: Anthem Medicare Advantage |
$12,255.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,255.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,255.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,255.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27,060.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,255.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29,578.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,255.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,255.98
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,255.98
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,255.98
|
| Rate for Payer: NAPHCARE Commercial |
$18,383.98
|
| Rate for Payer: Quartz Medicare Advantage |
$12,255.98
|
| Rate for Payer: The Alliance Commercial |
$40,659.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,255.98
|
| Rate for Payer: United Healthcare PPO |
$23,027.15
|
| Rate for Payer: Wellcare Medicare |
$12,255.98
|
|
|
MAJOR OPEN ABDOMINAL AND THORACIC VASCULAR PROCEDURES
|
Facility
|
OP
|
$1,827.87
|
|
|
Service Code
|
EAPG 00106
|
| Min. Negotiated Rate |
$1,757.56 |
| Max. Negotiated Rate |
$1,827.87 |
| Rate for Payer: Anthem Medicaid |
$1,757.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$1,757.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,757.56
|
| Rate for Payer: Dean Health Medicaid |
$1,757.56
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$1,757.56
|
| Rate for Payer: Managed Health Services Medicaid |
$1,827.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,757.56
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$1,757.56
|
| Rate for Payer: United Healthcare Medicaid |
$1,757.56
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$57,958.53
|
|
|
Service Code
|
APR-DRG 6804
|
| Min. Negotiated Rate |
$51,482.38 |
| Max. Negotiated Rate |
$57,958.53 |
| Rate for Payer: Anthem Medicaid |
$55,498.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$55,498.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$55,498.49
|
| Rate for Payer: Dean Health Medicaid |
$55,498.49
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$51,482.38
|
| Rate for Payer: Managed Health Services Medicaid |
$57,958.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$55,498.49
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$55,498.49
|
| Rate for Payer: United Healthcare Medicaid |
$55,498.49
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$19,904.06
|
|
|
Service Code
|
APR-DRG 6802
|
| Min. Negotiated Rate |
$17,680.03 |
| Max. Negotiated Rate |
$19,904.06 |
| Rate for Payer: Anthem Medicaid |
$19,059.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$19,059.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19,059.24
|
| Rate for Payer: Dean Health Medicaid |
$19,059.24
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17,680.03
|
| Rate for Payer: Managed Health Services Medicaid |
$19,904.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$19,059.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19,059.24
|
| Rate for Payer: United Healthcare Medicaid |
$19,059.24
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$14,467.71
|
|
|
Service Code
|
APR-DRG 6801
|
| Min. Negotiated Rate |
$12,851.12 |
| Max. Negotiated Rate |
$14,467.71 |
| Rate for Payer: Anthem Medicaid |
$13,853.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$13,853.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13,853.63
|
| Rate for Payer: Dean Health Medicaid |
$13,853.63
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12,851.12
|
| Rate for Payer: Managed Health Services Medicaid |
$14,467.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,853.63
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13,853.63
|
| Rate for Payer: United Healthcare Medicaid |
$13,853.63
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$31,565.92
|
|
|
Service Code
|
APR-DRG 6803
|
| Min. Negotiated Rate |
$28,038.82 |
| Max. Negotiated Rate |
$31,565.92 |
| Rate for Payer: Anthem Medicaid |
$30,226.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$30,226.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$30,226.10
|
| Rate for Payer: Dean Health Medicaid |
$30,226.10
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$28,038.82
|
| Rate for Payer: Managed Health Services Medicaid |
$31,565.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$30,226.10
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$30,226.10
|
| Rate for Payer: United Healthcare Medicaid |
$30,226.10
|
|
|
MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES
|
Facility
|
IP
|
$29,812.25
|
|
|
Service Code
|
APR-DRG 2603
|
| Min. Negotiated Rate |
$26,481.10 |
| Max. Negotiated Rate |
$29,812.25 |
| Rate for Payer: Anthem Medicaid |
$28,546.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$28,546.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28,546.88
|
| Rate for Payer: Dean Health Medicaid |
$28,546.88
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$26,481.10
|
| Rate for Payer: Managed Health Services Medicaid |
$29,812.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$28,546.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$28,546.88
|
| Rate for Payer: United Healthcare Medicaid |
$28,546.88
|
|
|
MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES
|
Facility
|
IP
|
$16,484.42
|
|
|
Service Code
|
APR-DRG 2601
|
| Min. Negotiated Rate |
$14,642.49 |
| Max. Negotiated Rate |
$16,484.42 |
| Rate for Payer: Anthem Medicaid |
$15,784.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$15,784.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15,784.74
|
| Rate for Payer: Dean Health Medicaid |
$15,784.74
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14,642.49
|
| Rate for Payer: Managed Health Services Medicaid |
$16,484.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$15,784.74
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$15,784.74
|
| Rate for Payer: United Healthcare Medicaid |
$15,784.74
|
|
|
MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES
|
Facility
|
IP
|
$22,446.87
|
|
|
Service Code
|
APR-DRG 2602
|
| Min. Negotiated Rate |
$19,938.71 |
| Max. Negotiated Rate |
$22,446.87 |
| Rate for Payer: Anthem Medicaid |
$21,494.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21,494.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,494.12
|
| Rate for Payer: Dean Health Medicaid |
$21,494.12
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19,938.71
|
| Rate for Payer: Managed Health Services Medicaid |
$22,446.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$21,494.12
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21,494.12
|
| Rate for Payer: United Healthcare Medicaid |
$21,494.12
|
|
|
MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES
|
Facility
|
IP
|
$50,330.10
|
|
|
Service Code
|
APR-DRG 2604
|
| Min. Negotiated Rate |
$44,706.33 |
| Max. Negotiated Rate |
$50,330.10 |
| Rate for Payer: Anthem Medicaid |
$48,193.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$48,193.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$48,193.84
|
| Rate for Payer: Dean Health Medicaid |
$48,193.84
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$44,706.33
|
| Rate for Payer: Managed Health Services Medicaid |
$50,330.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$48,193.84
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$48,193.84
|
| Rate for Payer: United Healthcare Medicaid |
$48,193.84
|
|
|
MAJOR RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$16,396.74
|
|
|
Service Code
|
APR-DRG 1201
|
| Min. Negotiated Rate |
$14,564.61 |
| Max. Negotiated Rate |
$16,396.74 |
| Rate for Payer: Anthem Medicaid |
$15,700.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$15,700.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15,700.78
|
| Rate for Payer: Dean Health Medicaid |
$15,700.78
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14,564.61
|
| Rate for Payer: Managed Health Services Medicaid |
$16,396.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$15,700.78
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$15,700.78
|
| Rate for Payer: United Healthcare Medicaid |
$15,700.78
|
|
|
MAJOR RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$48,576.44
|
|
|
Service Code
|
APR-DRG 1204
|
| Min. Negotiated Rate |
$43,148.62 |
| Max. Negotiated Rate |
$48,576.44 |
| Rate for Payer: Anthem Medicaid |
$46,514.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$46,514.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46,514.62
|
| Rate for Payer: Dean Health Medicaid |
$46,514.62
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$43,148.62
|
| Rate for Payer: Managed Health Services Medicaid |
$48,576.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$46,514.62
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$46,514.62
|
| Rate for Payer: United Healthcare Medicaid |
$46,514.62
|
|
|
MAJOR RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$20,342.48
|
|
|
Service Code
|
APR-DRG 1202
|
| Min. Negotiated Rate |
$18,069.46 |
| Max. Negotiated Rate |
$20,342.48 |
| Rate for Payer: Anthem Medicaid |
$19,479.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$19,479.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19,479.04
|
| Rate for Payer: Dean Health Medicaid |
$19,479.04
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,069.46
|
| Rate for Payer: Managed Health Services Medicaid |
$20,342.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$19,479.04
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19,479.04
|
| Rate for Payer: United Healthcare Medicaid |
$19,479.04
|
|
