|
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$39,982.80
|
|
|
Service Code
|
MSDRG 508
|
| Min. Negotiated Rate |
$12,104.35 |
| Max. Negotiated Rate |
$39,982.80 |
| Rate for Payer: Aetna Managed Medicare |
$12,104.35
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33,043.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25,327.19
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,062.48
|
| Rate for Payer: Anthem Medicare Advantage |
$12,104.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,104.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,104.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,104.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26,711.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,104.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29,081.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,104.35
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,104.35
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,104.35
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,104.35
|
| Rate for Payer: NAPHCARE Commercial |
$18,156.53
|
| Rate for Payer: Quartz Medicare Advantage |
$12,104.35
|
| Rate for Payer: The Alliance Commercial |
$39,982.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,104.35
|
| Rate for Payer: United Healthcare PPO |
$22,640.33
|
| Rate for Payer: Wellcare Medicare |
$12,104.35
|
|
|
MAJOR SKIN DIAGNOSES
|
Facility
|
OP
|
$26.68
|
|
|
Service Code
|
EAPG 00671
|
| Min. Negotiated Rate |
$25.65 |
| Max. Negotiated Rate |
$26.68 |
| Rate for Payer: Anthem Medicaid |
$25.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$25.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.65
|
| Rate for Payer: Dean Health Medicaid |
$25.65
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$25.65
|
| Rate for Payer: Managed Health Services Medicaid |
$26.68
|
| Rate for Payer: Molina Healthcare Medicaid |
$25.65
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$25.65
|
| Rate for Payer: United Healthcare Medicaid |
$25.65
|
|
|
MAJOR SKIN DISORDERS
|
Facility
|
IP
|
$7,453.06
|
|
|
Service Code
|
APR-DRG 3812
|
| Min. Negotiated Rate |
$6,620.28 |
| Max. Negotiated Rate |
$7,453.06 |
| Rate for Payer: Anthem Medicaid |
$7,136.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,136.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,136.72
|
| Rate for Payer: Dean Health Medicaid |
$7,136.72
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,620.28
|
| Rate for Payer: Managed Health Services Medicaid |
$7,453.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,136.72
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,136.72
|
| Rate for Payer: United Healthcare Medicaid |
$7,136.72
|
|
|
MAJOR SKIN DISORDERS
|
Facility
|
IP
|
$4,208.79
|
|
|
Service Code
|
APR-DRG 3811
|
| Min. Negotiated Rate |
$3,738.51 |
| Max. Negotiated Rate |
$4,208.79 |
| Rate for Payer: Anthem Medicaid |
$4,030.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,030.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,030.15
|
| Rate for Payer: Dean Health Medicaid |
$4,030.15
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3,738.51
|
| Rate for Payer: Managed Health Services Medicaid |
$4,208.79
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,030.15
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,030.15
|
| Rate for Payer: United Healthcare Medicaid |
$4,030.15
|
|
|
MAJOR SKIN DISORDERS
|
Facility
|
IP
|
$12,363.32
|
|
|
Service Code
|
APR-DRG 3813
|
| 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
|
|
|
MAJOR SKIN DISORDERS
|
Facility
|
IP
|
$25,603.47
|
|
|
Service Code
|
APR-DRG 3814
|
| Min. Negotiated Rate |
$22,742.60 |
| Max. Negotiated Rate |
$25,603.47 |
| Rate for Payer: Anthem Medicaid |
$24,516.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$24,516.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$24,516.73
|
| Rate for Payer: Dean Health Medicaid |
$24,516.73
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$22,742.60
|
| Rate for Payer: Managed Health Services Medicaid |
$25,603.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,516.73
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$24,516.73
|
| Rate for Payer: United Healthcare Medicaid |
$24,516.73
|
|
|
MAJOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$60,470.80
|
|
|
Service Code
|
MSDRG 595
|
| Min. Negotiated Rate |
$16,747.53 |
| Max. Negotiated Rate |
$60,470.80 |
| Rate for Payer: Aetna Managed Medicare |
$16,747.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$46,271.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35,467.10
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33,696.06
|
| Rate for Payer: Anthem Medicare Advantage |
$16,747.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16,747.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16,747.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16,747.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$37,405.71
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16,747.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44,109.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16,747.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16,747.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16,747.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16,747.53
|
| Rate for Payer: NAPHCARE Commercial |
$25,121.29
|
| Rate for Payer: Quartz Medicare Advantage |
$16,747.53
|
| Rate for Payer: The Alliance Commercial |
$60,470.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,747.53
|
| Rate for Payer: United Healthcare PPO |
$34,339.43
|
| Rate for Payer: Wellcare Medicare |
$16,747.53
|
|
|
MAJOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$28,231.84
|
|
|
Service Code
|
MSDRG 596
|
| Min. Negotiated Rate |
$8,796.78 |
| Max. Negotiated Rate |
$28,231.84 |
| Rate for Payer: Aetna Managed Medicare |
$8,796.78
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,619.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,103.99
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,199.97
|
| Rate for Payer: Anthem Medicare Advantage |
$8,796.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,796.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,796.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,796.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19,093.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,796.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,462.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,796.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,796.78
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,796.78
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,796.78
|
| Rate for Payer: NAPHCARE Commercial |
$13,195.17
|
| Rate for Payer: Quartz Medicare Advantage |
$8,796.78
|
| Rate for Payer: The Alliance Commercial |
$28,231.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,796.78
|
| Rate for Payer: United Healthcare PPO |
$15,930.34
|
| Rate for Payer: Wellcare Medicare |
$8,796.78
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$65,920.40
|
|
|
Service Code
|
MSDRG 330
|
| Min. Negotiated Rate |
$18,865.00 |
| Max. Negotiated Rate |
$65,920.40 |
| Rate for Payer: Aetna Managed Medicare |
$18,865.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$52,304.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$40,091.35
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$38,089.40
|
| Rate for Payer: Anthem Medicare Advantage |
$18,865.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,865.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,865.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,865.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$42,282.72
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,865.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,106.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,865.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,865.00
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,865.00
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,865.00
|
| Rate for Payer: NAPHCARE Commercial |
$28,297.50
|
| Rate for Payer: Quartz Medicare Advantage |
$18,865.00
|
| Rate for Payer: The Alliance Commercial |
$65,920.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,865.00
|
| Rate for Payer: United Healthcare PPO |
$37,451.28
|
| Rate for Payer: Wellcare Medicare |
$18,865.00
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$125,220.16
|
|
|
Service Code
|
MSDRG 329
|
| Min. Negotiated Rate |
$35,707.68 |
| Max. Negotiated Rate |
$125,220.16 |
| Rate for Payer: Aetna Managed Medicare |
$35,707.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$100,291.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$76,872.97
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$73,034.34
|
| Rate for Payer: Anthem Medicare Advantage |
$35,707.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35,707.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35,707.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$35,707.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81,074.81
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$35,707.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$91,600.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35,707.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35,707.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$35,707.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$35,707.68
|
| Rate for Payer: NAPHCARE Commercial |
$53,561.52
|
| Rate for Payer: Quartz Medicare Advantage |
$35,707.68
|
| Rate for Payer: The Alliance Commercial |
$125,220.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35,707.68
|
| Rate for Payer: United Healthcare PPO |
$71,312.32
|
| Rate for Payer: Wellcare Medicare |
$35,707.68
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$46,562.88
|
|
|
Service Code
|
MSDRG 331
|
| Min. Negotiated Rate |
$13,394.75 |
| Max. Negotiated Rate |
$46,562.88 |
| Rate for Payer: Aetna Managed Medicare |
$13,394.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$36,719.53
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28,145.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$26,739.80
|
| Rate for Payer: Anthem Medicare Advantage |
$13,394.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,394.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,394.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,394.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$29,683.63
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,394.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33,908.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,394.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,394.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,394.75
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,394.75
|
| Rate for Payer: NAPHCARE Commercial |
$20,092.13
|
| Rate for Payer: Quartz Medicare Advantage |
$13,394.75
|
| Rate for Payer: The Alliance Commercial |
$46,562.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,394.75
|
| Rate for Payer: United Healthcare PPO |
$26,397.94
|
| Rate for Payer: Wellcare Medicare |
$13,394.75
|
|
|
MAJOR SMALL BOWEL PROCEDURES
|
Facility
|
IP
|
$17,361.25
|
|
|
Service Code
|
APR-DRG 2302
|
| Min. Negotiated Rate |
$15,421.35 |
| Max. Negotiated Rate |
$17,361.25 |
| Rate for Payer: Anthem Medicaid |
$16,624.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$16,624.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16,624.36
|
| Rate for Payer: Dean Health Medicaid |
$16,624.36
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15,421.35
|
| Rate for Payer: Managed Health Services Medicaid |
$17,361.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,624.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16,624.36
|
| Rate for Payer: United Healthcare Medicaid |
$16,624.36
|
|
|
MAJOR SMALL BOWEL PROCEDURES
|
Facility
|
IP
|
$40,421.91
|
|
|
Service Code
|
APR-DRG 2304
|
| Min. Negotiated Rate |
$35,905.26 |
| Max. Negotiated Rate |
$40,421.91 |
| Rate for Payer: Anthem Medicaid |
$38,706.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$38,706.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$38,706.21
|
| Rate for Payer: Dean Health Medicaid |
$38,706.21
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$35,905.26
|
| Rate for Payer: Managed Health Services Medicaid |
$40,421.91
|
| Rate for Payer: Molina Healthcare Medicaid |
$38,706.21
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$38,706.21
|
| Rate for Payer: United Healthcare Medicaid |
$38,706.21
|
|
|
MAJOR SMALL BOWEL PROCEDURES
|
Facility
|
IP
|
$10,697.34
|
|
|
Service Code
|
APR-DRG 2301
|
| Min. Negotiated Rate |
$9,502.04 |
| Max. Negotiated Rate |
$10,697.34 |
| Rate for Payer: Anthem Medicaid |
$10,243.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,243.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,243.29
|
| Rate for Payer: Dean Health Medicaid |
$10,243.29
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,502.04
|
| Rate for Payer: Managed Health Services Medicaid |
$10,697.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,243.29
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,243.29
|
| Rate for Payer: United Healthcare Medicaid |
$10,243.29
|
|
|
MAJOR SMALL BOWEL PROCEDURES
|
Facility
|
IP
|
$25,515.78
|
|
|
Service Code
|
APR-DRG 2303
|
| Min. Negotiated Rate |
$22,664.71 |
| Max. Negotiated Rate |
$25,515.78 |
| Rate for Payer: Anthem Medicaid |
$24,432.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$24,432.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$24,432.77
|
| Rate for Payer: Dean Health Medicaid |
$24,432.77
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$22,664.71
|
| Rate for Payer: Managed Health Services Medicaid |
$25,515.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,432.77
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$24,432.77
|
| Rate for Payer: United Healthcare Medicaid |
$24,432.77
|
|
|
MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
|
IP
|
$28,497.01
|
|
|
Service Code
|
APR-DRG 2203
|
| Min. Negotiated Rate |
$25,312.82 |
| Max. Negotiated Rate |
$28,497.01 |
| Rate for Payer: Anthem Medicaid |
$27,287.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$27,287.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$27,287.46
|
| Rate for Payer: Dean Health Medicaid |
$27,287.46
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$25,312.82
|
| Rate for Payer: Managed Health Services Medicaid |
$28,497.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$27,287.46
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$27,287.46
|
| Rate for Payer: United Healthcare Medicaid |
$27,287.46
|
|
|
MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
|
IP
|
$47,787.29
|
|
|
Service Code
|
APR-DRG 2204
|
| Min. Negotiated Rate |
$42,447.65 |
| Max. Negotiated Rate |
$47,787.29 |
| Rate for Payer: Anthem Medicaid |
$45,758.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$45,758.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$45,758.96
|
| Rate for Payer: Dean Health Medicaid |
$45,758.96
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$42,447.65
|
| Rate for Payer: Managed Health Services Medicaid |
$47,787.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$45,758.96
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$45,758.96
|
| Rate for Payer: United Healthcare Medicaid |
$45,758.96
|
|
|
MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
|
IP
|
$19,465.65
|
|
|
Service Code
|
APR-DRG 2202
|
| Min. Negotiated Rate |
$17,290.60 |
| Max. Negotiated Rate |
$19,465.65 |
| Rate for Payer: Anthem Medicaid |
$18,639.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$18,639.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18,639.43
|
| Rate for Payer: Dean Health Medicaid |
$18,639.43
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17,290.60
|
| Rate for Payer: Managed Health Services Medicaid |
$19,465.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$18,639.43
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18,639.43
|
| Rate for Payer: United Healthcare Medicaid |
$18,639.43
|
|
|
MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
|
IP
|
$13,503.20
|
|
|
Service Code
|
APR-DRG 2201
|
| Min. Negotiated Rate |
$11,994.38 |
| Max. Negotiated Rate |
$13,503.20 |
| Rate for Payer: Anthem Medicaid |
$12,930.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,930.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,930.06
|
| Rate for Payer: Dean Health Medicaid |
$12,930.06
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,994.38
|
| Rate for Payer: Managed Health Services Medicaid |
$13,503.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,930.06
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,930.06
|
| Rate for Payer: United Healthcare Medicaid |
$12,930.06
|
|
|
MAJOR THUMB OR JOINT PROCEDURES
|
Facility
|
IP
|
$40,773.20
|
|
|
Service Code
|
MSDRG 506
|
| Min. Negotiated Rate |
$10,839.22 |
| Max. Negotiated Rate |
$40,773.20 |
| Rate for Payer: Aetna Managed Medicare |
$10,839.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$26,174.31
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,062.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,060.59
|
| Rate for Payer: Anthem Medicare Advantage |
$10,839.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,839.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,839.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,839.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21,159.00
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,839.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29,661.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,839.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,839.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,839.22
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,839.22
|
| Rate for Payer: NAPHCARE Commercial |
$16,258.83
|
| Rate for Payer: Quartz Medicare Advantage |
$10,839.22
|
| Rate for Payer: The Alliance Commercial |
$40,773.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,839.22
|
| Rate for Payer: United Healthcare PPO |
$23,091.88
|
| Rate for Payer: Wellcare Medicare |
$10,839.22
|
|
|
Malaria Smear
|
Facility
|
IP
|
$171.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
633784
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$87.14 |
| Max. Negotiated Rate |
$163.61 |
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$152.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$94.26
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cigna Commercial |
$163.61
|
| Rate for Payer: Health EOS Commercial |
$158.28
|
| Rate for Payer: HFN Commercial |
$163.61
|
| Rate for Payer: Multiplan Commercial |
$142.27
|
| Rate for Payer: Preferred Network Access Commercial |
$163.61
|
| Rate for Payer: Quartz Beloit One Network |
$87.14
|
| Rate for Payer: Quartz Commercial |
$106.70
|
| Rate for Payer: WEA Trust Commercial |
$97.81
|
| Rate for Payer: WPS Commercial |
$131.72
|
|
|
Malaria Smear
|
Facility
|
OP
|
$171.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
633784
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$163.61 |
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$152.94
|
| Rate for Payer: Aetna Managed Medicare |
$6.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.90
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.34
|
| Rate for Payer: Anthem Medicare Advantage |
$6.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$94.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.23
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cigna Commercial |
$163.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$99.52
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.23
|
| Rate for Payer: Health EOS Commercial |
$158.28
|
| Rate for Payer: HFN Commercial |
$163.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.23
|
| Rate for Payer: Multiplan Commercial |
$142.27
|
| Rate for Payer: NAPHCARE Commercial |
$9.34
|
| Rate for Payer: Preferred Network Access Commercial |
$163.61
|
| Rate for Payer: Quartz Beloit One Network |
$87.14
|
| Rate for Payer: Quartz Commercial |
$115.60
|
| Rate for Payer: Quartz Medicare Advantage |
$6.23
|
| Rate for Payer: The Alliance Commercial |
$24.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.23
|
| Rate for Payer: United Healthcare PPO |
$133.38
|
| Rate for Payer: WEA Trust Commercial |
$97.81
|
| Rate for Payer: Wellcare Medicare |
$6.23
|
| Rate for Payer: WPS Commercial |
$131.72
|
|
|
Malaria Smear
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
633784
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$168.95 |
| Rate for Payer: Aetna Commercial |
$168.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$152.94
|
| Rate for Payer: Aetna Managed Medicare |
$6.23
|
| Rate for Payer: Anthem Commercial |
$17.27
|
| Rate for Payer: Anthem Medicare Advantage |
$6.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.23
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cigna Commercial |
$168.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$88.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.23
|
| Rate for Payer: Health EOS Commercial |
$161.83
|
| Rate for Payer: HFN Commercial |
$168.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.99
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.23
|
| Rate for Payer: Multiplan Commercial |
$142.27
|
| Rate for Payer: NAPHCARE Commercial |
$9.34
|
| Rate for Payer: Preferred Network Access Commercial |
$168.95
|
| Rate for Payer: Quartz Beloit One Network |
$78.25
|
| Rate for Payer: Quartz Commercial |
$101.37
|
| Rate for Payer: Quartz Medicare Advantage |
$6.23
|
| Rate for Payer: The Alliance Commercial |
$24.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.23
|
| Rate for Payer: WEA Trust Commercial |
$97.81
|
| Rate for Payer: WPS Commercial |
$27.41
|
|
|
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY
|
Facility
|
IP
|
$18,764.18
|
|
|
Service Code
|
APR-DRG 5014
|
| Min. Negotiated Rate |
$16,667.52 |
| Max. Negotiated Rate |
$18,764.18 |
| Rate for Payer: Anthem Medicaid |
$17,967.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,967.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,967.74
|
| Rate for Payer: Dean Health Medicaid |
$17,967.74
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,667.52
|
| Rate for Payer: Managed Health Services Medicaid |
$18,764.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,967.74
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,967.74
|
| Rate for Payer: United Healthcare Medicaid |
$17,967.74
|
|
|
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY
|
Facility
|
IP
|
$9,119.04
|
|
|
Service Code
|
APR-DRG 5013
|
| 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
|
|
