|
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$61,072.96
|
|
|
Service Code
|
MSDRG 357
|
| Min. Negotiated Rate |
$18,315.91 |
| Max. Negotiated Rate |
$61,072.96 |
| Rate for Payer: Aetna Managed Medicare |
$18,315.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$50,740.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$38,892.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$36,950.15
|
| Rate for Payer: Anthem Medicare Advantage |
$18,315.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,315.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,315.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,315.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41,018.05
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,315.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44,551.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,315.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,315.91
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,315.91
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,315.91
|
| Rate for Payer: NAPHCARE Commercial |
$27,473.86
|
| Rate for Payer: Quartz Medicare Advantage |
$18,315.91
|
| Rate for Payer: The Alliance Commercial |
$61,072.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,315.91
|
| Rate for Payer: United Healthcare PPO |
$34,683.60
|
| Rate for Payer: Wellcare Medicare |
$18,315.91
|
|
|
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$118,636.96
|
|
|
Service Code
|
MSDRG 356
|
| Min. Negotiated Rate |
$34,147.71 |
| Max. Negotiated Rate |
$118,636.96 |
| Rate for Payer: Aetna Managed Medicare |
$34,147.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$95,847.38
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$73,466.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$69,797.73
|
| Rate for Payer: Anthem Medicare Advantage |
$34,147.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34,147.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34,147.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$34,147.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$77,481.88
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$34,147.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86,772.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$34,147.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34,147.71
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$34,147.71
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$34,147.71
|
| Rate for Payer: NAPHCARE Commercial |
$51,221.57
|
| Rate for Payer: Quartz Medicare Advantage |
$34,147.71
|
| Rate for Payer: The Alliance Commercial |
$118,636.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34,147.71
|
| Rate for Payer: United Healthcare PPO |
$67,553.14
|
| Rate for Payer: Wellcare Medicare |
$34,147.71
|
|
|
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$35,755.20
|
|
|
Service Code
|
MSDRG 358
|
| Min. Negotiated Rate |
$11,212.17 |
| Max. Negotiated Rate |
$35,755.20 |
| Rate for Payer: Aetna Managed Medicare |
$11,212.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$30,501.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23,378.82
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22,211.40
|
| Rate for Payer: Anthem Medicare Advantage |
$11,212.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11,212.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11,212.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11,212.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24,656.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11,212.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,980.71
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11,212.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11,212.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11,212.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11,212.17
|
| Rate for Payer: NAPHCARE Commercial |
$16,818.25
|
| Rate for Payer: Quartz Medicare Advantage |
$11,212.17
|
| Rate for Payer: The Alliance Commercial |
$35,755.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,212.17
|
| Rate for Payer: United Healthcare PPO |
$20,226.32
|
| Rate for Payer: Wellcare Medicare |
$11,212.17
|
|
|
OTHER DISORDERS OF NERVOUS SYSTEM
|
Facility
|
IP
|
$10,434.29
|
|
|
Service Code
|
APR-DRG 0582
|
| 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 DISORDERS OF NERVOUS SYSTEM
|
Facility
|
IP
|
$14,467.71
|
|
|
Service Code
|
APR-DRG 0583
|
| 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 DISORDERS OF NERVOUS SYSTEM
|
Facility
|
IP
|
$19,465.65
|
|
|
Service Code
|
APR-DRG 0584
|
| 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
|
|
|
OTHER DISORDERS OF NERVOUS SYSTEM
|
Facility
|
IP
|
$7,190.01
|
|
|
Service Code
|
APR-DRG 0581
|
| Min. Negotiated Rate |
$6,386.62 |
| Max. Negotiated Rate |
$7,190.01 |
| Rate for Payer: Anthem Medicaid |
$6,884.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,884.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,884.83
|
| Rate for Payer: Dean Health Medicaid |
$6,884.83
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,386.62
|
| Rate for Payer: Managed Health Services Medicaid |
$7,190.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,884.83
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,884.83
|
| Rate for Payer: United Healthcare Medicaid |
$6,884.83
|
|
|
OTHER DISORDERS OF NERVOUS SYSTEM WITH CC
|
Facility
|
IP
|
$28,704.00
|
|
|
Service Code
|
MSDRG 092
|
| Min. Negotiated Rate |
$8,341.11 |
| Max. Negotiated Rate |
$28,704.00 |
| Rate for Payer: Aetna Managed Medicare |
$8,341.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22,321.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17,108.90
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,254.57
|
| Rate for Payer: Anthem Medicare Advantage |
$8,341.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,341.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,341.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,341.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,044.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,341.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,809.31
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,341.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,341.11
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,341.11
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,341.11
|
| Rate for Payer: NAPHCARE Commercial |
$12,511.67
|
| Rate for Payer: Quartz Medicare Advantage |
$8,341.11
|
| Rate for Payer: The Alliance Commercial |
$28,704.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,341.11
|
| Rate for Payer: United Healthcare PPO |
$16,200.31
|
| Rate for Payer: Wellcare Medicare |
$8,341.11
|
|
|
OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC
|
Facility
|
IP
|
$49,803.52
|
|
|
Service Code
|
MSDRG 091
|
| Min. Negotiated Rate |
$13,956.10 |
| Max. Negotiated Rate |
$49,803.52 |
| Rate for Payer: Aetna Managed Medicare |
$13,956.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$38,318.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29,371.11
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27,904.47
|
| Rate for Payer: Anthem Medicare Advantage |
$13,956.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,956.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,956.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,956.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30,976.52
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,956.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36,284.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,956.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,956.10
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,956.10
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,956.10
|
| Rate for Payer: NAPHCARE Commercial |
$20,934.15
|
| Rate for Payer: Quartz Medicare Advantage |
$13,956.10
|
| Rate for Payer: The Alliance Commercial |
$49,803.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,956.10
|
| Rate for Payer: United Healthcare PPO |
$28,248.32
|
| Rate for Payer: Wellcare Medicare |
$13,956.10
|
|
|
OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$21,745.36
|
|
|
Service Code
|
MSDRG 093
|
| Min. Negotiated Rate |
$6,605.00 |
| Max. Negotiated Rate |
$21,745.36 |
| Rate for Payer: Aetna Managed Medicare |
$6,605.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,374.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13,317.51
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12,652.51
|
| Rate for Payer: Anthem Medicare Advantage |
$6,605.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,605.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,605.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,605.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14,045.44
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,605.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,704.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,605.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,605.00
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,605.00
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,605.00
|
| Rate for Payer: NAPHCARE Commercial |
$9,907.50
|
| Rate for Payer: Quartz Medicare Advantage |
$6,605.00
|
| Rate for Payer: The Alliance Commercial |
$21,745.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,605.00
|
| Rate for Payer: United Healthcare PPO |
$12,226.42
|
| Rate for Payer: Wellcare Medicare |
$6,605.00
|
|
|
OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT
|
Facility
|
IP
|
$36,882.56
|
|
|
Service Code
|
MSDRG 124
|
| Min. Negotiated Rate |
$10,965.83 |
| Max. Negotiated Rate |
$36,882.56 |
| Rate for Payer: Aetna Managed Medicare |
$10,965.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$28,868.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22,127.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21,022.89
|
| Rate for Payer: Anthem Medicare Advantage |
$10,965.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,965.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,965.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,965.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23,337.34
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,965.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,808.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,965.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,965.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,965.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,965.83
|
| Rate for Payer: NAPHCARE Commercial |
$16,448.75
|
| Rate for Payer: Quartz Medicare Advantage |
$10,965.83
|
| Rate for Payer: The Alliance Commercial |
$36,882.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,965.83
|
| Rate for Payer: United Healthcare PPO |
$20,870.47
|
| Rate for Payer: Wellcare Medicare |
$10,965.83
|
|
|
OTHER DISORDERS OF THE EYE WITHOUT MCC
|
Facility
|
IP
|
$22,383.92
|
|
|
Service Code
|
MSDRG 125
|
| Min. Negotiated Rate |
$6,386.74 |
| Max. Negotiated Rate |
$22,383.92 |
| Rate for Payer: Aetna Managed Medicare |
$6,386.74
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$16,752.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$12,840.87
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12,199.67
|
| Rate for Payer: Anthem Medicare Advantage |
$6,386.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,386.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,386.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,386.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13,542.75
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,386.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16,173.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,386.74
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,386.74
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,386.74
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,386.74
|
| Rate for Payer: NAPHCARE Commercial |
$9,580.12
|
| Rate for Payer: Quartz Medicare Advantage |
$6,386.74
|
| Rate for Payer: The Alliance Commercial |
$22,383.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,386.74
|
| Rate for Payer: United Healthcare PPO |
$12,591.12
|
| Rate for Payer: Wellcare Medicare |
$6,386.74
|
|
|
OTHER DISORDERS OF THE LIVER
|
Facility
|
IP
|
$7,190.01
|
|
|
Service Code
|
APR-DRG 2832
|
| Min. Negotiated Rate |
$6,386.62 |
| Max. Negotiated Rate |
$7,190.01 |
| Rate for Payer: Anthem Medicaid |
$6,884.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,884.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,884.83
|
| Rate for Payer: Dean Health Medicaid |
$6,884.83
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,386.62
|
| Rate for Payer: Managed Health Services Medicaid |
$7,190.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,884.83
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,884.83
|
| Rate for Payer: United Healthcare Medicaid |
$6,884.83
|
|
|
OTHER DISORDERS OF THE LIVER
|
Facility
|
IP
|
$10,960.39
|
|
|
Service Code
|
APR-DRG 2833
|
| Min. Negotiated Rate |
$9,735.70 |
| Max. Negotiated Rate |
$10,960.39 |
| Rate for Payer: Anthem Medicaid |
$10,495.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,495.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,495.17
|
| Rate for Payer: Dean Health Medicaid |
$10,495.17
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,735.70
|
| Rate for Payer: Managed Health Services Medicaid |
$10,960.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,495.17
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,495.17
|
| Rate for Payer: United Healthcare Medicaid |
$10,495.17
|
|
|
OTHER DISORDERS OF THE LIVER
|
Facility
|
IP
|
$20,430.16
|
|
|
Service Code
|
APR-DRG 2834
|
| Min. Negotiated Rate |
$18,147.34 |
| Max. Negotiated Rate |
$20,430.16 |
| Rate for Payer: Anthem Medicaid |
$19,563.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$19,563.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19,563.01
|
| Rate for Payer: Dean Health Medicaid |
$19,563.01
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,147.34
|
| Rate for Payer: Managed Health Services Medicaid |
$20,430.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$19,563.01
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19,563.01
|
| Rate for Payer: United Healthcare Medicaid |
$19,563.01
|
|
|
OTHER DISORDERS OF THE LIVER
|
Facility
|
IP
|
$5,173.30
|
|
|
Service Code
|
APR-DRG 2831
|
| Min. Negotiated Rate |
$4,595.25 |
| Max. Negotiated Rate |
$5,173.30 |
| Rate for Payer: Anthem Medicaid |
$4,953.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,953.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,953.72
|
| Rate for Payer: Dean Health Medicaid |
$4,953.72
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,595.25
|
| Rate for Payer: Managed Health Services Medicaid |
$5,173.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,953.72
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,953.72
|
| Rate for Payer: United Healthcare Medicaid |
$4,953.72
|
|
|
OTHER DRUG ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$3,244.27
|
|
|
Service Code
|
APR-DRG 7761
|
| Min. Negotiated Rate |
$2,881.77 |
| Max. Negotiated Rate |
$3,244.27 |
| Rate for Payer: Anthem Medicaid |
$3,106.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$3,106.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,106.57
|
| Rate for Payer: Dean Health Medicaid |
$3,106.57
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$2,881.77
|
| Rate for Payer: Managed Health Services Medicaid |
$3,244.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,106.57
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$3,106.57
|
| Rate for Payer: United Healthcare Medicaid |
$3,106.57
|
|
|
OTHER DRUG ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$4,384.15
|
|
|
Service Code
|
APR-DRG 7762
|
| Min. Negotiated Rate |
$3,894.28 |
| Max. Negotiated Rate |
$4,384.15 |
| Rate for Payer: Anthem Medicaid |
$4,198.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,198.07
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,198.07
|
| Rate for Payer: Dean Health Medicaid |
$4,198.07
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3,894.28
|
| Rate for Payer: Managed Health Services Medicaid |
$4,384.15
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,198.07
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,198.07
|
| Rate for Payer: United Healthcare Medicaid |
$4,198.07
|
|
|
OTHER DRUG ABUSE AND DEPENDENCE
|
Facility
|
OP
|
$104.82
|
|
|
Service Code
|
EAPG 00843
|
| Min. Negotiated Rate |
$100.79 |
| Max. Negotiated Rate |
$104.82 |
| Rate for Payer: Anthem Medicaid |
$100.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$100.79
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$100.79
|
| Rate for Payer: Dean Health Medicaid |
$100.79
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$100.79
|
| Rate for Payer: Managed Health Services Medicaid |
$104.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$100.79
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$100.79
|
| Rate for Payer: United Healthcare Medicaid |
$100.79
|
|
|
OTHER DRUG ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$15,870.64
|
|
|
Service Code
|
APR-DRG 7764
|
| Min. Negotiated Rate |
$14,097.29 |
| Max. Negotiated Rate |
$15,870.64 |
| Rate for Payer: Anthem Medicaid |
$15,197.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$15,197.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15,197.01
|
| Rate for Payer: Dean Health Medicaid |
$15,197.01
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14,097.29
|
| Rate for Payer: Managed Health Services Medicaid |
$15,870.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$15,197.01
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$15,197.01
|
| Rate for Payer: United Healthcare Medicaid |
$15,197.01
|
|
|
OTHER DRUG ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$8,329.89
|
|
|
Service Code
|
APR-DRG 7763
|
| Min. Negotiated Rate |
$7,399.13 |
| Max. Negotiated Rate |
$8,329.89 |
| Rate for Payer: Anthem Medicaid |
$7,976.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,976.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,976.33
|
| Rate for Payer: Dean Health Medicaid |
$7,976.33
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,399.13
|
| Rate for Payer: Managed Health Services Medicaid |
$8,329.89
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,976.33
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,976.33
|
| Rate for Payer: United Healthcare Medicaid |
$7,976.33
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC
|
Facility
|
IP
|
$26,506.48
|
|
|
Service Code
|
MSDRG 155
|
| Min. Negotiated Rate |
$7,525.52 |
| Max. Negotiated Rate |
$26,506.48 |
| Rate for Payer: Aetna Managed Medicare |
$7,525.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,997.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,327.77
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,562.38
|
| Rate for Payer: Anthem Medicare Advantage |
$7,525.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,525.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,525.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,525.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,165.58
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,525.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19,197.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,525.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,525.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,525.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,525.52
|
| Rate for Payer: NAPHCARE Commercial |
$11,288.28
|
| Rate for Payer: Quartz Medicare Advantage |
$7,525.52
|
| Rate for Payer: The Alliance Commercial |
$26,506.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,525.52
|
| Rate for Payer: United Healthcare PPO |
$14,945.14
|
| Rate for Payer: Wellcare Medicare |
$7,525.52
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC
|
Facility
|
IP
|
$42,863.60
|
|
|
Service Code
|
MSDRG 154
|
| Min. Negotiated Rate |
$12,480.38 |
| Max. Negotiated Rate |
$42,863.60 |
| Rate for Payer: Aetna Managed Medicare |
$12,480.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$34,114.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,148.35
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,842.64
|
| Rate for Payer: Anthem Medicare Advantage |
$12,480.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,480.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,480.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,480.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27,577.61
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,480.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31,194.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,480.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,480.38
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,480.38
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,480.38
|
| Rate for Payer: NAPHCARE Commercial |
$18,720.58
|
| Rate for Payer: Quartz Medicare Advantage |
$12,480.38
|
| Rate for Payer: The Alliance Commercial |
$42,863.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,480.38
|
| Rate for Payer: United Healthcare PPO |
$24,285.47
|
| Rate for Payer: Wellcare Medicare |
$12,480.38
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,457.92
|
|
|
Service Code
|
MSDRG 156
|
| Min. Negotiated Rate |
$5,799.35 |
| Max. Negotiated Rate |
$18,457.92 |
| Rate for Payer: Aetna Managed Medicare |
$5,799.35
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15,079.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,558.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,980.97
|
| Rate for Payer: Anthem Medicare Advantage |
$5,799.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,799.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,799.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,799.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,189.88
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,799.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13,293.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,799.35
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,799.35
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,799.35
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,799.35
|
| Rate for Payer: NAPHCARE Commercial |
$8,699.03
|
| Rate for Payer: Quartz Medicare Advantage |
$5,799.35
|
| Rate for Payer: The Alliance Commercial |
$18,457.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,799.35
|
| Rate for Payer: United Healthcare PPO |
$10,349.20
|
| Rate for Payer: Wellcare Medicare |
$5,799.35
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$48,180.08
|
|
|
Service Code
|
MSDRG 144
|
| Min. Negotiated Rate |
$13,777.66 |
| Max. Negotiated Rate |
$48,180.08 |
| Rate for Payer: Aetna Managed Medicare |
$13,777.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$37,810.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28,981.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27,534.26
|
| Rate for Payer: Anthem Medicare Advantage |
$13,777.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,777.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,777.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,777.66
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30,565.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,777.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35,094.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,777.66
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,777.66
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,777.66
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,777.66
|
| Rate for Payer: NAPHCARE Commercial |
$20,666.49
|
| Rate for Payer: Quartz Medicare Advantage |
$13,777.66
|
| Rate for Payer: The Alliance Commercial |
$48,180.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,777.66
|
| Rate for Payer: United Healthcare PPO |
$27,321.55
|
| Rate for Payer: Wellcare Medicare |
$13,777.66
|
|
