|
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC
|
Facility
|
IP
|
$27,078.48
|
|
|
Service Code
|
MSDRG 315
|
| Min. Negotiated Rate |
$7,883.92 |
| Max. Negotiated Rate |
$27,078.48 |
| Rate for Payer: Aetna Managed Medicare |
$7,883.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$21,018.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,110.46
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,305.99
|
| Rate for Payer: Anthem Medicare Advantage |
$7,883.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,883.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,883.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,883.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,991.05
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,883.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19,616.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,883.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,883.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,883.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,883.92
|
| Rate for Payer: NAPHCARE Commercial |
$11,825.88
|
| Rate for Payer: Quartz Medicare Advantage |
$7,883.92
|
| Rate for Payer: The Alliance Commercial |
$27,078.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,883.92
|
| Rate for Payer: United Healthcare PPO |
$15,271.96
|
| Rate for Payer: Wellcare Medicare |
$7,883.92
|
|
|
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$58,217.12
|
|
|
Service Code
|
MSDRG 314
|
| Min. Negotiated Rate |
$16,475.66 |
| Max. Negotiated Rate |
$58,217.12 |
| Rate for Payer: Aetna Managed Medicare |
$16,475.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$45,497.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$34,873.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33,131.99
|
| Rate for Payer: Anthem Medicare Advantage |
$16,475.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16,475.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16,475.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16,475.66
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36,779.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16,475.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42,456.18
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16,475.66
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16,475.66
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16,475.66
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16,475.66
|
| Rate for Payer: NAPHCARE Commercial |
$24,713.49
|
| Rate for Payer: Quartz Medicare Advantage |
$16,475.66
|
| Rate for Payer: The Alliance Commercial |
$58,217.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,475.66
|
| Rate for Payer: United Healthcare PPO |
$33,052.68
|
| Rate for Payer: Wellcare Medicare |
$16,475.66
|
|
|
OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,486.48
|
|
|
Service Code
|
MSDRG 316
|
| Min. Negotiated Rate |
$5,730.44 |
| Max. Negotiated Rate |
$19,486.48 |
| Rate for Payer: Aetna Managed Medicare |
$5,730.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14,882.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,407.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,837.97
|
| Rate for Payer: Anthem Medicare Advantage |
$5,730.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,730.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,730.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,730.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,031.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,730.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,047.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,730.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,730.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,730.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,730.44
|
| Rate for Payer: NAPHCARE Commercial |
$8,595.66
|
| Rate for Payer: Quartz Medicare Advantage |
$5,730.44
|
| Rate for Payer: The Alliance Commercial |
$19,486.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,730.44
|
| Rate for Payer: United Healthcare PPO |
$10,936.52
|
| Rate for Payer: Wellcare Medicare |
$5,730.44
|
|
|
OTHER CIRCULATORY SYSTEM O.R. PROCEDURES
|
Facility
|
IP
|
$90,636.00
|
|
|
Service Code
|
MSDRG 264
|
| Min. Negotiated Rate |
$26,089.74 |
| Max. Negotiated Rate |
$90,636.00 |
| Rate for Payer: Aetna Managed Medicare |
$26,089.74
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$72,889.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$55,869.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$53,079.19
|
| Rate for Payer: Anthem Medicare Advantage |
$26,089.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$26,089.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$26,089.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$26,089.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$58,922.77
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$26,089.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66,234.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$26,089.74
|
| Rate for Payer: Independent Care Health Plan Medicare |
$26,089.74
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$26,089.74
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$26,089.74
|
| Rate for Payer: NAPHCARE Commercial |
$39,134.61
|
| Rate for Payer: Quartz Medicare Advantage |
$26,089.74
|
| Rate for Payer: The Alliance Commercial |
$90,636.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,089.74
|
| Rate for Payer: United Healthcare PPO |
$51,564.40
|
| Rate for Payer: Wellcare Medicare |
$26,089.74
|
|
|
OTHER CIRCULATORY SYSTEM PROCEDURES
|
Facility
|
IP
|
$12,714.05
|
|
|
Service Code
|
APR-DRG 1801
|
| Min. Negotiated Rate |
$11,293.41 |
| Max. Negotiated Rate |
$12,714.05 |
| Rate for Payer: Anthem Medicaid |
$12,174.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,174.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,174.40
|
| Rate for Payer: Dean Health Medicaid |
$12,174.40
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,293.41
|
| Rate for Payer: Managed Health Services Medicaid |
$12,714.05
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,174.40
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,174.40
|
| Rate for Payer: United Healthcare Medicaid |
$12,174.40
|
|
|
OTHER CIRCULATORY SYSTEM PROCEDURES
|
Facility
|
IP
|
$33,757.99
|
|
|
Service Code
|
APR-DRG 1804
|
| Min. Negotiated Rate |
$29,985.96 |
| Max. Negotiated Rate |
$33,757.99 |
| Rate for Payer: Anthem Medicaid |
$32,325.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$32,325.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$32,325.14
|
| Rate for Payer: Dean Health Medicaid |
$32,325.14
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$29,985.96
|
| Rate for Payer: Managed Health Services Medicaid |
$33,757.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$32,325.14
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$32,325.14
|
| Rate for Payer: United Healthcare Medicaid |
$32,325.14
|
|
|
OTHER CIRCULATORY SYSTEM PROCEDURES
|
Facility
|
IP
|
$14,467.71
|
|
|
Service Code
|
APR-DRG 1802
|
| Min. Negotiated Rate |
$12,851.12 |
| Max. Negotiated Rate |
$14,467.71 |
| Rate for Payer: Anthem Medicaid |
$13,853.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$13,853.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13,853.63
|
| Rate for Payer: Dean Health Medicaid |
$13,853.63
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12,851.12
|
| Rate for Payer: Managed Health Services Medicaid |
$14,467.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,853.63
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13,853.63
|
| Rate for Payer: United Healthcare Medicaid |
$13,853.63
|
|
|
OTHER CIRCULATORY SYSTEM PROCEDURES
|
Facility
|
IP
|
$20,956.26
|
|
|
Service Code
|
APR-DRG 1803
|
| Min. Negotiated Rate |
$18,614.66 |
| Max. Negotiated Rate |
$20,956.26 |
| Rate for Payer: Anthem Medicaid |
$20,066.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20,066.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20,066.77
|
| Rate for Payer: Dean Health Medicaid |
$20,066.77
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,614.66
|
| Rate for Payer: Managed Health Services Medicaid |
$20,956.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$20,066.77
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20,066.77
|
| Rate for Payer: United Healthcare Medicaid |
$20,066.77
|
|
|
OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
IP
|
$5,348.67
|
|
|
Service Code
|
APR-DRG 8131
|
| Min. Negotiated Rate |
$4,751.02 |
| Max. Negotiated Rate |
$5,348.67 |
| Rate for Payer: Anthem Medicaid |
$5,121.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$5,121.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,121.65
|
| Rate for Payer: Dean Health Medicaid |
$5,121.65
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,751.02
|
| Rate for Payer: Managed Health Services Medicaid |
$5,348.67
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,121.65
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5,121.65
|
| Rate for Payer: United Healthcare Medicaid |
$5,121.65
|
|
|
OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
IP
|
$10,609.66
|
|
|
Service Code
|
APR-DRG 8133
|
| Min. Negotiated Rate |
$9,424.16 |
| Max. Negotiated Rate |
$10,609.66 |
| Rate for Payer: Anthem Medicaid |
$10,159.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,159.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,159.33
|
| Rate for Payer: Dean Health Medicaid |
$10,159.33
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,424.16
|
| Rate for Payer: Managed Health Services Medicaid |
$10,609.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,159.33
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,159.33
|
| Rate for Payer: United Healthcare Medicaid |
$10,159.33
|
|
|
OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
IP
|
$7,277.70
|
|
|
Service Code
|
APR-DRG 8132
|
| Min. Negotiated Rate |
$6,464.50 |
| Max. Negotiated Rate |
$7,277.70 |
| Rate for Payer: Anthem Medicaid |
$6,968.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,968.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,968.80
|
| Rate for Payer: Dean Health Medicaid |
$6,968.80
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,464.50
|
| Rate for Payer: Managed Health Services Medicaid |
$7,277.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,968.80
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,968.80
|
| Rate for Payer: United Healthcare Medicaid |
$6,968.80
|
|
|
OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
IP
|
$18,764.18
|
|
|
Service Code
|
APR-DRG 8134
|
| 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
|
|
|
OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
OP
|
$112.69
|
|
|
Service Code
|
EAPG 00852
|
| Min. Negotiated Rate |
$108.35 |
| Max. Negotiated Rate |
$112.69 |
| Rate for Payer: Anthem Medicaid |
$108.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$108.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$108.35
|
| Rate for Payer: Dean Health Medicaid |
$108.35
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$108.35
|
| Rate for Payer: Managed Health Services Medicaid |
$112.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$108.35
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$108.35
|
| Rate for Payer: United Healthcare Medicaid |
$108.35
|
|
|
OTHER CRANIOTOMY PROCEDURES INCLUDING CRANIOPLASTY
|
Facility
|
OP
|
$1,931.38
|
|
|
Service Code
|
EAPG 00267
|
| Min. Negotiated Rate |
$1,857.09 |
| Max. Negotiated Rate |
$1,931.38 |
| Rate for Payer: Anthem Medicaid |
$1,857.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$1,857.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,857.09
|
| Rate for Payer: Dean Health Medicaid |
$1,857.09
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$1,857.09
|
| Rate for Payer: Managed Health Services Medicaid |
$1,931.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,857.09
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$1,857.09
|
| Rate for Payer: United Healthcare Medicaid |
$1,857.09
|
|
|
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES
|
Facility
|
IP
|
$10,434.29
|
|
|
Service Code
|
APR-DRG 2291
|
| Min. Negotiated Rate |
$9,268.39 |
| Max. Negotiated Rate |
$10,434.29 |
| Rate for Payer: Anthem Medicaid |
$9,991.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$9,991.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9,991.41
|
| Rate for Payer: Dean Health Medicaid |
$9,991.41
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,268.39
|
| Rate for Payer: Managed Health Services Medicaid |
$10,434.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,991.41
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$9,991.41
|
| Rate for Payer: United Healthcare Medicaid |
$9,991.41
|
|
|
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES
|
Facility
|
IP
|
$22,008.46
|
|
|
Service Code
|
APR-DRG 2293
|
| Min. Negotiated Rate |
$19,549.29 |
| Max. Negotiated Rate |
$22,008.46 |
| Rate for Payer: Anthem Medicaid |
$21,074.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21,074.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,074.31
|
| Rate for Payer: Dean Health Medicaid |
$21,074.31
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19,549.29
|
| Rate for Payer: Managed Health Services Medicaid |
$22,008.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$21,074.31
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21,074.31
|
| Rate for Payer: United Healthcare Medicaid |
$21,074.31
|
|
|
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES
|
Facility
|
IP
|
$14,818.44
|
|
|
Service Code
|
APR-DRG 2292
|
| Min. Negotiated Rate |
$13,162.67 |
| Max. Negotiated Rate |
$14,818.44 |
| Rate for Payer: Anthem Medicaid |
$14,189.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$14,189.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14,189.48
|
| Rate for Payer: Dean Health Medicaid |
$14,189.48
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$13,162.67
|
| Rate for Payer: Managed Health Services Medicaid |
$14,818.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,189.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14,189.48
|
| Rate for Payer: United Healthcare Medicaid |
$14,189.48
|
|
|
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES
|
Facility
|
IP
|
$35,248.61
|
|
|
Service Code
|
APR-DRG 2294
|
| Min. Negotiated Rate |
$31,310.01 |
| Max. Negotiated Rate |
$35,248.61 |
| Rate for Payer: Anthem Medicaid |
$33,752.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$33,752.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$33,752.48
|
| Rate for Payer: Dean Health Medicaid |
$33,752.48
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$31,310.01
|
| Rate for Payer: Managed Health Services Medicaid |
$35,248.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$33,752.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$33,752.48
|
| Rate for Payer: United Healthcare Medicaid |
$33,752.48
|
|
|
OTHER DIGESTIVE SYSTEM DIAGNOSES
|
Facility
|
IP
|
$17,448.94
|
|
|
Service Code
|
APR-DRG 2544
|
| Min. Negotiated Rate |
$15,499.23 |
| Max. Negotiated Rate |
$17,448.94 |
| Rate for Payer: Anthem Medicaid |
$16,708.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$16,708.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16,708.32
|
| Rate for Payer: Dean Health Medicaid |
$16,708.32
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15,499.23
|
| Rate for Payer: Managed Health Services Medicaid |
$17,448.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,708.32
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16,708.32
|
| Rate for Payer: United Healthcare Medicaid |
$16,708.32
|
|
|
OTHER DIGESTIVE SYSTEM DIAGNOSES
|
Facility
|
IP
|
$10,346.61
|
|
|
Service Code
|
APR-DRG 2543
|
| Min. Negotiated Rate |
$9,190.50 |
| Max. Negotiated Rate |
$10,346.61 |
| Rate for Payer: Anthem Medicaid |
$9,907.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$9,907.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9,907.45
|
| Rate for Payer: Dean Health Medicaid |
$9,907.45
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,190.50
|
| Rate for Payer: Managed Health Services Medicaid |
$10,346.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,907.45
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$9,907.45
|
| Rate for Payer: United Healthcare Medicaid |
$9,907.45
|
|
|
OTHER DIGESTIVE SYSTEM DIAGNOSES
|
Facility
|
IP
|
$6,926.96
|
|
|
Service Code
|
APR-DRG 2542
|
| Min. Negotiated Rate |
$6,152.96 |
| Max. Negotiated Rate |
$6,926.96 |
| Rate for Payer: Anthem Medicaid |
$6,632.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,632.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,632.95
|
| Rate for Payer: Dean Health Medicaid |
$6,632.95
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,152.96
|
| Rate for Payer: Managed Health Services Medicaid |
$6,926.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,632.95
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,632.95
|
| Rate for Payer: United Healthcare Medicaid |
$6,632.95
|
|
|
OTHER DIGESTIVE SYSTEM DIAGNOSES
|
Facility
|
IP
|
$5,348.67
|
|
|
Service Code
|
APR-DRG 2541
|
| Min. Negotiated Rate |
$4,751.02 |
| Max. Negotiated Rate |
$5,348.67 |
| Rate for Payer: Anthem Medicaid |
$5,121.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$5,121.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,121.65
|
| Rate for Payer: Dean Health Medicaid |
$5,121.65
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,751.02
|
| Rate for Payer: Managed Health Services Medicaid |
$5,348.67
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,121.65
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5,121.65
|
| Rate for Payer: United Healthcare Medicaid |
$5,121.65
|
|
|
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC
|
Facility
|
IP
|
$26,238.16
|
|
|
Service Code
|
MSDRG 394
|
| Min. Negotiated Rate |
$7,672.56 |
| Max. Negotiated Rate |
$26,238.16 |
| Rate for Payer: Aetna Managed Medicare |
$7,672.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,416.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,648.87
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,867.45
|
| Rate for Payer: Anthem Medicare Advantage |
$7,672.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,672.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,672.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,672.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,504.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,672.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19,000.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,672.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,672.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,672.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,672.56
|
| Rate for Payer: NAPHCARE Commercial |
$11,508.84
|
| Rate for Payer: Quartz Medicare Advantage |
$7,672.56
|
| Rate for Payer: The Alliance Commercial |
$26,238.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,672.56
|
| Rate for Payer: United Healthcare PPO |
$14,792.00
|
| Rate for Payer: Wellcare Medicare |
$7,672.56
|
|
|
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$45,114.16
|
|
|
Service Code
|
MSDRG 393
|
| Min. Negotiated Rate |
$12,754.54 |
| Max. Negotiated Rate |
$45,114.16 |
| Rate for Payer: Aetna Managed Medicare |
$12,754.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$34,895.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,747.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25,411.47
|
| Rate for Payer: Anthem Medicare Advantage |
$12,754.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,754.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,754.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,754.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28,209.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,754.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,845.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,754.54
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,754.54
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,754.54
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,754.54
|
| Rate for Payer: NAPHCARE Commercial |
$19,131.81
|
| Rate for Payer: Quartz Medicare Advantage |
$12,754.54
|
| Rate for Payer: The Alliance Commercial |
$45,114.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,754.54
|
| Rate for Payer: United Healthcare PPO |
$25,570.64
|
| Rate for Payer: Wellcare Medicare |
$12,754.54
|
|
|
OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,236.40
|
|
|
Service Code
|
MSDRG 395
|
| Min. Negotiated Rate |
$5,476.95 |
| Max. Negotiated Rate |
$18,236.40 |
| Rate for Payer: Aetna Managed Medicare |
$5,476.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14,160.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10,854.03
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,312.04
|
| Rate for Payer: Anthem Medicare Advantage |
$5,476.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,476.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,476.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,476.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,447.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,476.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13,131.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,476.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,476.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,476.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,476.95
|
| Rate for Payer: NAPHCARE Commercial |
$8,215.43
|
| Rate for Payer: Quartz Medicare Advantage |
$5,476.95
|
| Rate for Payer: The Alliance Commercial |
$18,236.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,476.95
|
| Rate for Payer: United Healthcare PPO |
$10,222.89
|
| Rate for Payer: Wellcare Medicare |
$5,476.95
|
|
