|
MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
IP
|
$11,223.44
|
|
|
Service Code
|
APR-DRG 3493
|
| Min. Negotiated Rate |
$9,969.36 |
| Max. Negotiated Rate |
$11,223.44 |
| Rate for Payer: Anthem Medicaid |
$10,747.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,747.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,747.06
|
| Rate for Payer: Dean Health Medicaid |
$10,747.06
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,969.36
|
| Rate for Payer: Managed Health Services Medicaid |
$11,223.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,747.06
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,747.06
|
| Rate for Payer: United Healthcare Medicaid |
$10,747.06
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
IP
|
$5,699.40
|
|
|
Service Code
|
APR-DRG 3491
|
| Min. Negotiated Rate |
$5,062.56 |
| Max. Negotiated Rate |
$5,699.40 |
| Rate for Payer: Anthem Medicaid |
$5,457.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$5,457.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,457.49
|
| Rate for Payer: Dean Health Medicaid |
$5,457.49
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,062.56
|
| Rate for Payer: Managed Health Services Medicaid |
$5,699.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,457.49
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5,457.49
|
| Rate for Payer: United Healthcare Medicaid |
$5,457.49
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
IP
|
$7,803.80
|
|
|
Service Code
|
APR-DRG 3492
|
| Min. Negotiated Rate |
$6,931.82 |
| Max. Negotiated Rate |
$7,803.80 |
| Rate for Payer: Anthem Medicaid |
$7,472.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,472.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,472.56
|
| Rate for Payer: Dean Health Medicaid |
$7,472.56
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,931.82
|
| Rate for Payer: Managed Health Services Medicaid |
$7,803.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,472.56
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,472.56
|
| Rate for Payer: United Healthcare Medicaid |
$7,472.56
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
IP
|
$18,588.82
|
|
|
Service Code
|
APR-DRG 3494
|
| Min. Negotiated Rate |
$16,511.75 |
| Max. Negotiated Rate |
$18,588.82 |
| Rate for Payer: Anthem Medicaid |
$17,799.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,799.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,799.82
|
| Rate for Payer: Dean Health Medicaid |
$17,799.82
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,511.75
|
| Rate for Payer: Managed Health Services Medicaid |
$18,588.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,799.82
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,799.82
|
| Rate for Payer: United Healthcare Medicaid |
$17,799.82
|
|
|
MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC
|
Facility
|
OP
|
$150.68
|
|
|
Service Code
|
EAPG 00725
|
| Min. Negotiated Rate |
$144.89 |
| Max. Negotiated Rate |
$150.68 |
| Rate for Payer: Anthem Medicaid |
$144.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$144.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$144.89
|
| Rate for Payer: Dean Health Medicaid |
$144.89
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$144.89
|
| Rate for Payer: Managed Health Services Medicaid |
$150.68
|
| Rate for Payer: Molina Healthcare Medicaid |
$144.89
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$144.89
|
| Rate for Payer: United Healthcare Medicaid |
$144.89
|
|
|
MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
EAPG 00659
|
| Min. Negotiated Rate |
$109.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Anthem Medicaid |
$109.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$109.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$109.61
|
| Rate for Payer: Dean Health Medicaid |
$109.61
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$109.61
|
| Rate for Payer: Managed Health Services Medicaid |
$114.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$109.61
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$109.61
|
| Rate for Payer: United Healthcare Medicaid |
$109.61
|
|
|
MALFUNCTION, REACTION, OR COMPLICATION OF CARDIOVASCULAR DEVICE OR PROC
|
Facility
|
OP
|
$107.44
|
|
|
Service Code
|
EAPG 00589
|
| Min. Negotiated Rate |
$103.31 |
| Max. Negotiated Rate |
$107.44 |
| Rate for Payer: Anthem Medicaid |
$103.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$103.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$103.31
|
| Rate for Payer: Dean Health Medicaid |
$103.31
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$103.31
|
| Rate for Payer: Managed Health Services Medicaid |
$107.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$103.31
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$103.31
|
| Rate for Payer: United Healthcare Medicaid |
$103.31
|
|
|
MALFUNCTION, REACTION, OR COMPLICATION OF OCULAR DEVICE OR PROCEDURE
|
Facility
|
OP
|
$110.07
|
|
|
Service Code
|
EAPG 00558
|
| Min. Negotiated Rate |
$105.83 |
| Max. Negotiated Rate |
$110.07 |
| Rate for Payer: Anthem Medicaid |
$105.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$105.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$105.83
|
| Rate for Payer: Dean Health Medicaid |
$105.83
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$105.83
|
| Rate for Payer: Managed Health Services Medicaid |
$110.07
|
| Rate for Payer: Molina Healthcare Medicaid |
$105.83
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$105.83
|
| Rate for Payer: United Healthcare Medicaid |
$105.83
|
|
|
MALFUNCTION, REACTION, OR COMPLICATION OF OTOLARYNGOLOGIC DEVICE OR PROCEDURE
|
Facility
|
OP
|
$99.58
|
|
|
Service Code
|
EAPG 00566
|
| Min. Negotiated Rate |
$95.75 |
| Max. Negotiated Rate |
$99.58 |
| Rate for Payer: Anthem Medicaid |
$95.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$95.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$95.75
|
| Rate for Payer: Dean Health Medicaid |
$95.75
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$95.75
|
| Rate for Payer: Managed Health Services Medicaid |
$99.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$95.75
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$95.75
|
| Rate for Payer: United Healthcare Medicaid |
$95.75
|
|
|
MALFUNCTION, REACTION, OR COMPLICATION OF PULMONARY DEVICE OR PROCEDURE
|
Facility
|
OP
|
$108.75
|
|
|
Service Code
|
EAPG 00583
|
| Min. Negotiated Rate |
$104.57 |
| Max. Negotiated Rate |
$108.75 |
| Rate for Payer: Anthem Medicaid |
$104.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$104.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$104.57
|
| Rate for Payer: Dean Health Medicaid |
$104.57
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$104.57
|
| Rate for Payer: Managed Health Services Medicaid |
$108.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$104.57
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$104.57
|
| Rate for Payer: United Healthcare Medicaid |
$104.57
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$30,324.32
|
|
|
Service Code
|
MSDRG 755
|
| Min. Negotiated Rate |
$8,837.37 |
| Max. Negotiated Rate |
$30,324.32 |
| Rate for Payer: Aetna Managed Medicare |
$8,837.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,734.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,192.63
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,284.18
|
| Rate for Payer: Anthem Medicare Advantage |
$8,837.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,837.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,837.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,837.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19,187.03
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,837.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,997.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,837.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,837.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,837.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,837.37
|
| Rate for Payer: NAPHCARE Commercial |
$13,256.05
|
| Rate for Payer: Quartz Medicare Advantage |
$8,837.37
|
| Rate for Payer: The Alliance Commercial |
$30,324.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,837.37
|
| Rate for Payer: United Healthcare PPO |
$17,125.50
|
| Rate for Payer: Wellcare Medicare |
$8,837.37
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$51,553.84
|
|
|
Service Code
|
MSDRG 754
|
| Min. Negotiated Rate |
$14,610.87 |
| Max. Negotiated Rate |
$51,553.84 |
| Rate for Payer: Aetna Managed Medicare |
$14,610.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$40,184.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30,801.03
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29,262.99
|
| Rate for Payer: Anthem Medicare Advantage |
$14,610.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,610.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,610.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,610.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32,484.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,610.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37,568.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,610.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,610.87
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,610.87
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,610.87
|
| Rate for Payer: NAPHCARE Commercial |
$21,916.30
|
| Rate for Payer: Quartz Medicare Advantage |
$14,610.87
|
| Rate for Payer: The Alliance Commercial |
$51,553.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,610.87
|
| Rate for Payer: United Healthcare PPO |
$29,247.71
|
| Rate for Payer: Wellcare Medicare |
$14,610.87
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$27,698.32
|
|
|
Service Code
|
MSDRG 756
|
| Min. Negotiated Rate |
$7,862.47 |
| Max. Negotiated Rate |
$27,698.32 |
| Rate for Payer: Aetna Managed Medicare |
$7,862.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,957.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,063.63
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,261.50
|
| Rate for Payer: Anthem Medicare Advantage |
$7,862.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,862.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,862.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,862.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,941.66
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,862.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,071.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,862.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,862.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,862.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,862.47
|
| Rate for Payer: NAPHCARE Commercial |
$11,793.71
|
| Rate for Payer: Quartz Medicare Advantage |
$7,862.47
|
| Rate for Payer: The Alliance Commercial |
$27,698.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,862.47
|
| Rate for Payer: United Healthcare PPO |
$15,625.63
|
| Rate for Payer: Wellcare Medicare |
$7,862.47
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM
|
Facility
|
IP
|
$6,400.87
|
|
|
Service Code
|
APR-DRG 5001
|
| Min. Negotiated Rate |
$5,685.65 |
| Max. Negotiated Rate |
$6,400.87 |
| Rate for Payer: Anthem Medicaid |
$6,129.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,129.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,129.18
|
| Rate for Payer: Dean Health Medicaid |
$6,129.18
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,685.65
|
| Rate for Payer: Managed Health Services Medicaid |
$6,400.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,129.18
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,129.18
|
| Rate for Payer: United Healthcare Medicaid |
$6,129.18
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM
|
Facility
|
IP
|
$11,398.80
|
|
|
Service Code
|
APR-DRG 5003
|
| Min. Negotiated Rate |
$10,125.13 |
| Max. Negotiated Rate |
$11,398.80 |
| Rate for Payer: Anthem Medicaid |
$10,914.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,914.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,914.98
|
| Rate for Payer: Dean Health Medicaid |
$10,914.98
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,125.13
|
| Rate for Payer: Managed Health Services Medicaid |
$11,398.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,914.98
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,914.98
|
| Rate for Payer: United Healthcare Medicaid |
$10,914.98
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM
|
Facility
|
IP
|
$17,887.35
|
|
|
Service Code
|
APR-DRG 5004
|
| Min. Negotiated Rate |
$15,888.66 |
| Max. Negotiated Rate |
$17,887.35 |
| Rate for Payer: Anthem Medicaid |
$17,128.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,128.13
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,128.13
|
| Rate for Payer: Dean Health Medicaid |
$17,128.13
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15,888.66
|
| Rate for Payer: Managed Health Services Medicaid |
$17,887.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,128.13
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,128.13
|
| Rate for Payer: United Healthcare Medicaid |
$17,128.13
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM
|
Facility
|
IP
|
$7,540.75
|
|
|
Service Code
|
APR-DRG 5002
|
| Min. Negotiated Rate |
$6,698.16 |
| Max. Negotiated Rate |
$7,540.75 |
| Rate for Payer: Anthem Medicaid |
$7,220.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,220.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,220.68
|
| Rate for Payer: Dean Health Medicaid |
$7,220.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,698.16
|
| Rate for Payer: Managed Health Services Medicaid |
$7,540.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,220.68
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,220.68
|
| Rate for Payer: United Healthcare Medicaid |
$7,220.68
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$31,142.80
|
|
|
Service Code
|
MSDRG 723
|
| Min. Negotiated Rate |
$9,257.80 |
| Max. Negotiated Rate |
$31,142.80 |
| Rate for Payer: Aetna Managed Medicare |
$9,257.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24,932.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,110.79
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18,156.50
|
| Rate for Payer: Anthem Medicare Advantage |
$9,257.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,257.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,257.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,257.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20,155.38
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,257.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22,598.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,257.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,257.80
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,257.80
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,257.80
|
| Rate for Payer: NAPHCARE Commercial |
$13,886.70
|
| Rate for Payer: Quartz Medicare Advantage |
$9,257.80
|
| Rate for Payer: The Alliance Commercial |
$31,142.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,257.80
|
| Rate for Payer: United Healthcare PPO |
$17,592.84
|
| Rate for Payer: Wellcare Medicare |
$9,257.80
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$52,170.56
|
|
|
Service Code
|
MSDRG 722
|
| Min. Negotiated Rate |
$14,365.81 |
| Max. Negotiated Rate |
$52,170.56 |
| Rate for Payer: Aetna Managed Medicare |
$14,365.81
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$39,486.21
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30,265.86
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28,754.54
|
| Rate for Payer: Anthem Medicare Advantage |
$14,365.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,365.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,365.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,365.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31,920.18
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,365.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$38,020.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,365.81
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,365.81
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,365.81
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,365.81
|
| Rate for Payer: NAPHCARE Commercial |
$21,548.72
|
| Rate for Payer: Quartz Medicare Advantage |
$14,365.81
|
| Rate for Payer: The Alliance Commercial |
$52,170.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,365.81
|
| Rate for Payer: United Healthcare PPO |
$29,599.79
|
| Rate for Payer: Wellcare Medicare |
$14,365.81
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$22,715.68
|
|
|
Service Code
|
MSDRG 724
|
| Min. Negotiated Rate |
$5,528.26 |
| Max. Negotiated Rate |
$22,715.68 |
| Rate for Payer: Aetna Managed Medicare |
$5,528.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$13,346.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10,230.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9,719.37
|
| Rate for Payer: Anthem Medicare Advantage |
$5,528.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,528.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,528.26
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,528.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10,789.40
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,528.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16,416.66
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,528.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,528.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,528.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,528.26
|
| Rate for Payer: NAPHCARE Commercial |
$8,292.38
|
| Rate for Payer: Quartz Medicare Advantage |
$5,528.26
|
| Rate for Payer: The Alliance Commercial |
$22,715.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,528.26
|
| Rate for Payer: United Healthcare PPO |
$12,780.58
|
| Rate for Payer: Wellcare Medicare |
$5,528.26
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS
|
Facility
|
IP
|
$6,839.28
|
|
|
Service Code
|
APR-DRG 2811
|
| Min. Negotiated Rate |
$6,075.08 |
| Max. Negotiated Rate |
$6,839.28 |
| Rate for Payer: Anthem Medicaid |
$6,548.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,548.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,548.99
|
| Rate for Payer: Dean Health Medicaid |
$6,548.99
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,075.08
|
| Rate for Payer: Managed Health Services Medicaid |
$6,839.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,548.99
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,548.99
|
| Rate for Payer: United Healthcare Medicaid |
$6,548.99
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS
|
Facility
|
IP
|
$12,363.32
|
|
|
Service Code
|
APR-DRG 2813
|
| Min. Negotiated Rate |
$10,981.87 |
| Max. Negotiated Rate |
$12,363.32 |
| Rate for Payer: Anthem Medicaid |
$11,838.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$11,838.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11,838.56
|
| Rate for Payer: Dean Health Medicaid |
$11,838.56
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,981.87
|
| Rate for Payer: Managed Health Services Medicaid |
$12,363.32
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,838.56
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11,838.56
|
| Rate for Payer: United Healthcare Medicaid |
$11,838.56
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS
|
Facility
|
IP
|
$18,851.87
|
|
|
Service Code
|
APR-DRG 2814
|
| Min. Negotiated Rate |
$16,745.40 |
| Max. Negotiated Rate |
$18,851.87 |
| Rate for Payer: Anthem Medicaid |
$18,051.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$18,051.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18,051.70
|
| Rate for Payer: Dean Health Medicaid |
$18,051.70
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,745.40
|
| Rate for Payer: Managed Health Services Medicaid |
$18,851.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$18,051.70
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18,051.70
|
| Rate for Payer: United Healthcare Medicaid |
$18,051.70
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS
|
Facility
|
IP
|
$9,119.04
|
|
|
Service Code
|
APR-DRG 2812
|
| Min. Negotiated Rate |
$8,100.10 |
| Max. Negotiated Rate |
$9,119.04 |
| Rate for Payer: Anthem Medicaid |
$8,731.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$8,731.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8,731.99
|
| Rate for Payer: Dean Health Medicaid |
$8,731.99
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8,100.10
|
| Rate for Payer: Managed Health Services Medicaid |
$9,119.04
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,731.99
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8,731.99
|
| Rate for Payer: United Healthcare Medicaid |
$8,731.99
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC
|
Facility
|
IP
|
$30,767.36
|
|
|
Service Code
|
MSDRG 436
|
| Min. Negotiated Rate |
$9,168.97 |
| Max. Negotiated Rate |
$30,767.36 |
| Rate for Payer: Aetna Managed Medicare |
$9,168.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24,679.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,916.79
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,972.18
|
| Rate for Payer: Anthem Medicare Advantage |
$9,168.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,168.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,168.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,168.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19,950.77
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,168.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22,322.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,168.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,168.97
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,168.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,168.97
|
| Rate for Payer: NAPHCARE Commercial |
$13,753.46
|
| Rate for Payer: Quartz Medicare Advantage |
$9,168.97
|
| Rate for Payer: The Alliance Commercial |
$30,767.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,168.97
|
| Rate for Payer: United Healthcare PPO |
$17,378.12
|
| Rate for Payer: Wellcare Medicare |
$9,168.97
|
|
