|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC
|
Facility
|
IP
|
$44,304.00
|
|
|
Service Code
|
MSDRG 698
|
| Min. Negotiated Rate |
$15,936.78 |
| Max. Negotiated Rate |
$44,304.00 |
| Rate for Payer: Aetna Managed Medicare |
$15,936.78
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$34,617.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,533.65
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25,208.70
|
| Rate for Payer: Anthem Medicare Advantage |
$15,936.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,936.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,936.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,936.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27,983.97
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,936.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,260.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,936.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,936.78
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,936.78
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,936.78
|
| Rate for Payer: NAPHCARE Commercial |
$23,905.17
|
| Rate for Payer: Quartz Medicare Advantage |
$15,936.78
|
| Rate for Payer: The Alliance Commercial |
$44,304.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,936.78
|
| Rate for Payer: United Healthcare PPO |
$25,115.45
|
| Rate for Payer: Wellcare Medicare |
$15,936.78
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,151.00
|
|
|
Service Code
|
MSDRG 700
|
| Min. Negotiated Rate |
$6,888.95 |
| Max. Negotiated Rate |
$19,151.00 |
| Rate for Payer: Aetna Managed Medicare |
$6,888.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14,895.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,417.51
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,847.38
|
| Rate for Payer: Anthem Medicare Advantage |
$6,888.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,888.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,888.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,888.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,041.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,888.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13,811.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,888.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,888.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,888.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,888.95
|
| Rate for Payer: NAPHCARE Commercial |
$10,333.42
|
| Rate for Payer: Quartz Medicare Advantage |
$6,888.95
|
| Rate for Payer: The Alliance Commercial |
$19,151.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,888.95
|
| Rate for Payer: United Healthcare PPO |
$10,752.70
|
| Rate for Payer: Wellcare Medicare |
$6,888.95
|
|
|
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC
|
Facility
|
IP
|
$63,654.00
|
|
|
Service Code
|
MSDRG 674
|
| Min. Negotiated Rate |
$22,896.95 |
| Max. Negotiated Rate |
$63,654.00 |
| Rate for Payer: Aetna Managed Medicare |
$22,896.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$49,932.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$38,272.78
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$36,361.64
|
| Rate for Payer: Anthem Medicare Advantage |
$22,896.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$22,896.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$22,896.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$22,896.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40,364.75
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$22,896.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46,452.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22,896.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$22,896.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$22,896.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$22,896.95
|
| Rate for Payer: NAPHCARE Commercial |
$34,345.42
|
| Rate for Payer: Quartz Medicare Advantage |
$22,896.95
|
| Rate for Payer: The Alliance Commercial |
$63,654.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,896.95
|
| Rate for Payer: United Healthcare PPO |
$36,164.18
|
| Rate for Payer: Wellcare Medicare |
$22,896.95
|
|
|
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC
|
Facility
|
IP
|
$98,635.00
|
|
|
Service Code
|
MSDRG 673
|
| Min. Negotiated Rate |
$35,480.33 |
| Max. Negotiated Rate |
$98,635.00 |
| Rate for Payer: Aetna Managed Medicare |
$35,480.33
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$77,626.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$59,499.70
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$56,528.60
|
| Rate for Payer: Anthem Medicare Advantage |
$35,480.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35,480.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35,480.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$35,480.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$62,751.93
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$35,480.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$72,111.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35,480.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35,480.33
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$35,480.33
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$35,480.33
|
| Rate for Payer: NAPHCARE Commercial |
$53,220.50
|
| Rate for Payer: Quartz Medicare Advantage |
$35,480.33
|
| Rate for Payer: The Alliance Commercial |
$98,635.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35,480.33
|
| Rate for Payer: United Healthcare PPO |
$56,139.34
|
| Rate for Payer: Wellcare Medicare |
$35,480.33
|
|
|
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$42,499.00
|
|
|
Service Code
|
MSDRG 675
|
| Min. Negotiated Rate |
$15,287.44 |
| Max. Negotiated Rate |
$42,499.00 |
| Rate for Payer: Aetna Managed Medicare |
$15,287.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33,358.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25,568.79
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,292.02
|
| Rate for Payer: Anthem Medicare Advantage |
$15,287.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,287.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,287.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,287.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26,966.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,287.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,936.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,287.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,287.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,287.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,287.44
|
| Rate for Payer: NAPHCARE Commercial |
$22,931.16
|
| Rate for Payer: Quartz Medicare Advantage |
$15,287.44
|
| Rate for Payer: The Alliance Commercial |
$42,499.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,287.44
|
| Rate for Payer: United Healthcare PPO |
$24,084.66
|
| Rate for Payer: Wellcare Medicare |
$15,287.44
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$92,207.00
|
|
|
Service Code
|
MSDRG 271
|
| Min. Negotiated Rate |
$33,167.92 |
| Max. Negotiated Rate |
$92,207.00 |
| Rate for Payer: Aetna Managed Medicare |
$33,167.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$72,590.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$55,640.26
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$52,861.88
|
| Rate for Payer: Anthem Medicare Advantage |
$33,167.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33,167.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33,167.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$33,167.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$58,681.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$33,167.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$67,395.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$33,167.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33,167.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$33,167.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$33,167.92
|
| Rate for Payer: NAPHCARE Commercial |
$49,751.88
|
| Rate for Payer: Quartz Medicare Advantage |
$33,167.92
|
| Rate for Payer: The Alliance Commercial |
$92,207.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,167.92
|
| Rate for Payer: United Healthcare PPO |
$52,468.57
|
| Rate for Payer: Wellcare Medicare |
$33,167.92
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$134,763.00
|
|
|
Service Code
|
MSDRG 270
|
| Min. Negotiated Rate |
$48,475.90 |
| Max. Negotiated Rate |
$134,763.00 |
| Rate for Payer: Aetna Managed Medicare |
$48,475.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$106,158.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$81,369.86
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$77,306.68
|
| Rate for Payer: Anthem Medicare Advantage |
$48,475.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$48,475.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$48,475.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$48,475.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$85,817.50
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$48,475.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$98,609.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$48,475.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$48,475.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$48,475.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$48,475.90
|
| Rate for Payer: NAPHCARE Commercial |
$72,713.85
|
| Rate for Payer: Quartz Medicare Advantage |
$48,475.90
|
| Rate for Payer: The Alliance Commercial |
$134,763.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48,475.90
|
| Rate for Payer: United Healthcare PPO |
$76,768.80
|
| Rate for Payer: Wellcare Medicare |
$48,475.90
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$65,177.00
|
|
|
Service Code
|
MSDRG 272
|
| Min. Negotiated Rate |
$23,444.93 |
| Max. Negotiated Rate |
$65,177.00 |
| Rate for Payer: Aetna Managed Medicare |
$23,444.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$51,191.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$39,237.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$37,278.32
|
| Rate for Payer: Anthem Medicare Advantage |
$23,444.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23,444.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23,444.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23,444.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41,382.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23,444.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$47,570.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23,444.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23,444.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23,444.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23,444.93
|
| Rate for Payer: NAPHCARE Commercial |
$35,167.40
|
| Rate for Payer: Quartz Medicare Advantage |
$23,444.93
|
| Rate for Payer: The Alliance Commercial |
$65,177.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,444.93
|
| Rate for Payer: United Healthcare PPO |
$37,034.05
|
| Rate for Payer: Wellcare Medicare |
$23,444.93
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
|
Facility
|
IP
|
$27,010.00
|
|
|
Service Code
|
MSDRG 729
|
| Min. Negotiated Rate |
$9,715.85 |
| Max. Negotiated Rate |
$27,010.00 |
| Rate for Payer: Aetna Managed Medicare |
$9,715.85
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,980.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$9,715.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,715.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,715.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,715.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,959.98
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,715.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19,576.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,715.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,715.85
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,715.85
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,715.85
|
| Rate for Payer: NAPHCARE Commercial |
$14,573.78
|
| Rate for Payer: Quartz Medicare Advantage |
$9,715.85
|
| Rate for Payer: The Alliance Commercial |
$27,010.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,715.85
|
| Rate for Payer: United Healthcare PPO |
$15,240.21
|
| Rate for Payer: Wellcare Medicare |
$9,715.85
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,846.00
|
|
|
Service Code
|
MSDRG 730
|
| Min. Negotiated Rate |
$6,059.81 |
| Max. Negotiated Rate |
$16,846.00 |
| Rate for Payer: Aetna Managed Medicare |
$6,059.81
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$13,007.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9,970.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9,472.36
|
| Rate for Payer: Anthem Medicare Advantage |
$6,059.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,059.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,059.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,059.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10,515.19
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,059.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,121.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,059.81
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,059.81
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,059.81
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,059.81
|
| Rate for Payer: NAPHCARE Commercial |
$9,089.72
|
| Rate for Payer: Quartz Medicare Advantage |
$6,059.81
|
| Rate for Payer: The Alliance Commercial |
$16,846.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,059.81
|
| Rate for Payer: United Healthcare PPO |
$9,436.51
|
| Rate for Payer: Wellcare Medicare |
$6,059.81
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$48,539.00
|
|
|
Service Code
|
MSDRG 717
|
| Min. Negotiated Rate |
$17,460.20 |
| Max. Negotiated Rate |
$48,539.00 |
| Rate for Payer: Wellcare Medicare |
$17,460.20
|
| Rate for Payer: Aetna Managed Medicare |
$17,460.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$37,973.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29,106.61
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27,653.18
|
| Rate for Payer: Anthem Medicare Advantage |
$17,460.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17,460.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17,460.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17,460.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30,697.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17,460.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35,367.15
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17,460.20
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17,460.20
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17,460.20
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17,460.20
|
| Rate for Payer: NAPHCARE Commercial |
$26,190.30
|
| Rate for Payer: Quartz Medicare Advantage |
$17,460.20
|
| Rate for Payer: The Alliance Commercial |
$48,539.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,460.20
|
| Rate for Payer: United Healthcare PPO |
$27,533.78
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$31,580.00
|
|
|
Service Code
|
MSDRG 718
|
| Min. Negotiated Rate |
$11,359.78 |
| Max. Negotiated Rate |
$31,580.00 |
| Rate for Payer: Aetna Managed Medicare |
$11,359.78
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24,756.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,975.58
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18,028.04
|
| Rate for Payer: Anthem Medicare Advantage |
$11,359.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11,359.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11,359.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11,359.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20,012.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11,359.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22,928.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11,359.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11,359.78
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11,359.78
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11,359.78
|
| Rate for Payer: NAPHCARE Commercial |
$17,039.67
|
| Rate for Payer: Quartz Medicare Advantage |
$11,359.78
|
| Rate for Payer: The Alliance Commercial |
$31,580.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,359.78
|
| Rate for Payer: United Healthcare PPO |
$17,849.82
|
| Rate for Payer: Wellcare Medicare |
$11,359.78
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$59,009.00
|
|
|
Service Code
|
MSDRG 715
|
| Min. Negotiated Rate |
$21,226.24 |
| Max. Negotiated Rate |
$59,009.00 |
| Rate for Payer: Aetna Managed Medicare |
$21,226.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$46,365.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35,539.01
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33,764.38
|
| Rate for Payer: Anthem Medicare Advantage |
$21,226.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21,226.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21,226.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$21,226.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$37,481.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$21,226.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$43,046.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21,226.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21,226.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$21,226.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$21,226.24
|
| Rate for Payer: NAPHCARE Commercial |
$31,839.36
|
| Rate for Payer: Quartz Medicare Advantage |
$21,226.24
|
| Rate for Payer: The Alliance Commercial |
$59,009.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,226.24
|
| Rate for Payer: United Healthcare PPO |
$33,512.06
|
| Rate for Payer: Wellcare Medicare |
$21,226.24
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$38,131.00
|
|
|
Service Code
|
MSDRG 716
|
| Min. Negotiated Rate |
$13,716.18 |
| Max. Negotiated Rate |
$38,131.00 |
| Rate for Payer: Aetna Managed Medicare |
$13,716.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,791.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22,835.02
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21,694.76
|
| Rate for Payer: Anthem Medicare Advantage |
$13,716.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,716.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,716.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,716.18
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24,083.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,716.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$27,732.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,716.18
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,716.18
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,716.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,716.18
|
| Rate for Payer: NAPHCARE Commercial |
$20,574.27
|
| Rate for Payer: Quartz Medicare Advantage |
$13,716.18
|
| Rate for Payer: The Alliance Commercial |
$38,131.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,716.18
|
| Rate for Payer: United Healthcare PPO |
$21,590.42
|
| Rate for Payer: Wellcare Medicare |
$13,716.18
|
|
|
OTHER MENTAL DISORDER DIAGNOSES
|
Facility
|
IP
|
$34,765.00
|
|
|
Service Code
|
MSDRG 887
|
| Min. Negotiated Rate |
$12,505.46 |
| Max. Negotiated Rate |
$34,765.00 |
| Rate for Payer: Aetna Managed Medicare |
$12,505.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$27,274.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,905.30
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,861.40
|
| Rate for Payer: Anthem Medicare Advantage |
$12,505.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,505.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,505.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,505.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22,047.97
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,505.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,264.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,505.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,505.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,505.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,505.46
|
| Rate for Payer: NAPHCARE Commercial |
$18,758.19
|
| Rate for Payer: Quartz Medicare Advantage |
$12,505.46
|
| Rate for Payer: The Alliance Commercial |
$34,765.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,505.46
|
| Rate for Payer: United Healthcare PPO |
$19,668.50
|
| Rate for Payer: Wellcare Medicare |
$12,505.46
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC
|
Facility
|
IP
|
$40,226.00
|
|
|
Service Code
|
MSDRG 964
|
| Min. Negotiated Rate |
$14,469.77 |
| Max. Negotiated Rate |
$40,226.00 |
| Rate for Payer: Aetna Managed Medicare |
$14,469.77
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31,470.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24,121.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22,917.00
|
| Rate for Payer: Anthem Medicare Advantage |
$14,469.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,469.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,469.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,469.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25,439.97
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,469.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29,269.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,469.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,469.77
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,469.77
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,469.77
|
| Rate for Payer: NAPHCARE Commercial |
$21,704.66
|
| Rate for Payer: Quartz Medicare Advantage |
$14,469.77
|
| Rate for Payer: The Alliance Commercial |
$40,226.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,469.77
|
| Rate for Payer: United Healthcare PPO |
$22,786.68
|
| Rate for Payer: Wellcare Medicare |
$14,469.77
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$73,014.00
|
|
|
Service Code
|
MSDRG 963
|
| Min. Negotiated Rate |
$26,264.18 |
| Max. Negotiated Rate |
$73,014.00 |
| Rate for Payer: Aetna Managed Medicare |
$26,264.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$57,275.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43,901.13
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41,708.94
|
| Rate for Payer: Anthem Medicare Advantage |
$26,264.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$26,264.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$26,264.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$26,264.18
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$46,300.75
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$26,264.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53,318.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$26,264.18
|
| Rate for Payer: Independent Care Health Plan Medicare |
$26,264.18
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$26,264.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$26,264.18
|
| Rate for Payer: NAPHCARE Commercial |
$39,396.27
|
| Rate for Payer: Quartz Medicare Advantage |
$26,264.18
|
| Rate for Payer: The Alliance Commercial |
$73,014.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,264.18
|
| Rate for Payer: United Healthcare PPO |
$41,509.41
|
| Rate for Payer: Wellcare Medicare |
$26,264.18
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$25,734.00
|
|
|
Service Code
|
MSDRG 965
|
| Min. Negotiated Rate |
$9,256.81 |
| Max. Negotiated Rate |
$25,734.00 |
| Rate for Payer: Wellcare Medicare |
$9,256.81
|
| Rate for Payer: Aetna Managed Medicare |
$9,256.81
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,140.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,437.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,666.88
|
| Rate for Payer: Anthem Medicare Advantage |
$9,256.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,256.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,256.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,256.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,281.58
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,256.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18,640.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,256.81
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,256.81
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,256.81
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,256.81
|
| Rate for Payer: NAPHCARE Commercial |
$13,885.22
|
| Rate for Payer: Quartz Medicare Advantage |
$9,256.81
|
| Rate for Payer: The Alliance Commercial |
$25,734.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,256.81
|
| Rate for Payer: United Healthcare PPO |
$14,511.52
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC
|
Facility
|
IP
|
$26,890.00
|
|
|
Service Code
|
MSDRG 565
|
| Min. Negotiated Rate |
$9,672.83 |
| Max. Negotiated Rate |
$26,890.00 |
| Rate for Payer: Aetna Managed Medicare |
$9,672.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,980.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$9,672.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,672.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,672.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,672.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,959.98
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,672.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19,488.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,672.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,672.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,672.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,672.83
|
| Rate for Payer: NAPHCARE Commercial |
$14,509.24
|
| Rate for Payer: Quartz Medicare Advantage |
$9,672.83
|
| Rate for Payer: The Alliance Commercial |
$26,890.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,672.83
|
| Rate for Payer: United Healthcare PPO |
$15,171.89
|
| Rate for Payer: Wellcare Medicare |
$9,672.83
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC
|
Facility
|
IP
|
$41,845.00
|
|
|
Service Code
|
MSDRG 564
|
| Min. Negotiated Rate |
$15,052.17 |
| Max. Negotiated Rate |
$41,845.00 |
| Rate for Payer: Aetna Managed Medicare |
$15,052.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$32,728.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25,086.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23,833.68
|
| Rate for Payer: Anthem Medicare Advantage |
$15,052.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,052.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,052.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,052.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26,457.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,052.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,457.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,052.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,052.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,052.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,052.17
|
| Rate for Payer: NAPHCARE Commercial |
$22,578.26
|
| Rate for Payer: Quartz Medicare Advantage |
$15,052.17
|
| Rate for Payer: The Alliance Commercial |
$41,845.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,052.17
|
| Rate for Payer: United Healthcare PPO |
$23,711.20
|
| Rate for Payer: Wellcare Medicare |
$15,052.17
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,273.00
|
|
|
Service Code
|
MSDRG 566
|
| Min. Negotiated Rate |
$7,292.52 |
| Max. Negotiated Rate |
$20,273.00 |
| Rate for Payer: Aetna Managed Medicare |
$7,292.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15,735.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$12,060.75
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11,458.50
|
| Rate for Payer: Anthem Medicare Advantage |
$7,292.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,292.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,292.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,292.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,719.98
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,292.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,634.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,292.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,292.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,292.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,292.52
|
| Rate for Payer: NAPHCARE Commercial |
$10,938.78
|
| Rate for Payer: Quartz Medicare Advantage |
$7,292.52
|
| Rate for Payer: The Alliance Commercial |
$20,273.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,292.52
|
| Rate for Payer: United Healthcare PPO |
$11,393.34
|
| Rate for Payer: Wellcare Medicare |
$7,292.52
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$54,577.00
|
|
|
Service Code
|
MSDRG 516
|
| Min. Negotiated Rate |
$19,632.03 |
| Max. Negotiated Rate |
$54,577.00 |
| Rate for Payer: Aetna Managed Medicare |
$19,632.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$42,799.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32,805.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$31,167.12
|
| Rate for Payer: Anthem Medicare Advantage |
$19,632.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19,632.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19,632.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$19,632.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34,598.36
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$19,632.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39,795.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19,632.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19,632.03
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$19,632.03
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$19,632.03
|
| Rate for Payer: NAPHCARE Commercial |
$29,448.04
|
| Rate for Payer: Quartz Medicare Advantage |
$19,632.03
|
| Rate for Payer: The Alliance Commercial |
$54,577.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,632.03
|
| Rate for Payer: United Healthcare PPO |
$30,981.38
|
| Rate for Payer: Wellcare Medicare |
$19,632.03
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$84,372.00
|
|
|
Service Code
|
MSDRG 515
|
| Min. Negotiated Rate |
$30,349.63 |
| Max. Negotiated Rate |
$84,372.00 |
| Rate for Payer: Aetna Managed Medicare |
$30,349.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$66,296.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$50,815.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$48,278.48
|
| Rate for Payer: Anthem Medicare Advantage |
$30,349.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30,349.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30,349.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$30,349.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$53,593.54
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$30,349.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61,649.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30,349.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30,349.63
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$30,349.63
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$30,349.63
|
| Rate for Payer: NAPHCARE Commercial |
$45,524.44
|
| Rate for Payer: Quartz Medicare Advantage |
$30,349.63
|
| Rate for Payer: The Alliance Commercial |
$84,372.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,349.63
|
| Rate for Payer: United Healthcare PPO |
$47,994.73
|
| Rate for Payer: Wellcare Medicare |
$30,349.63
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,050.00
|
|
|
Service Code
|
MSDRG 517
|
| Min. Negotiated Rate |
$14,406.65 |
| Max. Negotiated Rate |
$40,050.00 |
| Rate for Payer: Aetna Managed Medicare |
$14,406.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31,260.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23,960.69
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22,764.22
|
| Rate for Payer: Anthem Medicare Advantage |
$14,406.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,406.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,406.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,406.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25,270.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,406.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29,140.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,406.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,406.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,406.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,406.65
|
| Rate for Payer: NAPHCARE Commercial |
$21,609.98
|
| Rate for Payer: Quartz Medicare Advantage |
$14,406.65
|
| Rate for Payer: The Alliance Commercial |
$40,050.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,406.65
|
| Rate for Payer: United Healthcare PPO |
$22,686.49
|
| Rate for Payer: Wellcare Medicare |
$14,406.65
|
|
|
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC
|
Facility
|
IP
|
$31,086.00
|
|
|
Service Code
|
MSDRG 844
|
| Min. Negotiated Rate |
$11,181.91 |
| Max. Negotiated Rate |
$31,086.00 |
| Rate for Payer: Wellcare Medicare |
$11,181.91
|
| Rate for Payer: United Healthcare PPO |
$17,567.45
|
| Rate for Payer: Aetna Managed Medicare |
$11,181.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24,336.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,653.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,722.48
|
| Rate for Payer: Anthem Medicare Advantage |
$11,181.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11,181.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11,181.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11,181.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19,673.58
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11,181.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22,565.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11,181.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11,181.91
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11,181.91
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11,181.91
|
| Rate for Payer: NAPHCARE Commercial |
$16,772.86
|
| Rate for Payer: Quartz Medicare Advantage |
$11,181.91
|
| Rate for Payer: The Alliance Commercial |
$31,086.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,181.91
|
|
