|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS
|
Facility
|
OP
|
$95.65
|
|
|
Service Code
|
EAPG 00726
|
| Min. Negotiated Rate |
$91.97 |
| Max. Negotiated Rate |
$95.65 |
| Rate for Payer: Anthem Medicaid |
$91.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$91.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$91.97
|
| Rate for Payer: Dean Health Medicaid |
$91.97
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$91.97
|
| Rate for Payer: Managed Health Services Medicaid |
$95.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$91.97
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$91.97
|
| Rate for Payer: United Healthcare Medicaid |
$91.97
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC
|
Facility
|
IP
|
$28,557.36
|
|
|
Service Code
|
MSDRG 699
|
| Min. Negotiated Rate |
$8,279.86 |
| Max. Negotiated Rate |
$28,557.36 |
| Rate for Payer: Aetna Managed Medicare |
$8,279.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22,146.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,975.10
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,127.46
|
| Rate for Payer: Anthem Medicare Advantage |
$8,279.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,279.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,279.86
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,279.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17,902.96
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,279.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,701.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,279.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,279.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,279.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,279.86
|
| Rate for Payer: NAPHCARE Commercial |
$12,419.78
|
| Rate for Payer: Quartz Medicare Advantage |
$8,279.86
|
| Rate for Payer: The Alliance Commercial |
$28,557.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,279.86
|
| Rate for Payer: United Healthcare PPO |
$16,116.63
|
| Rate for Payer: Wellcare Medicare |
$8,279.86
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC
|
Facility
|
IP
|
$46,076.16
|
|
|
Service Code
|
MSDRG 698
|
| Min. Negotiated Rate |
$13,176.50 |
| Max. Negotiated Rate |
$46,076.16 |
| Rate for Payer: Aetna Managed Medicare |
$13,176.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$36,097.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27,668.58
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$26,286.96
|
| Rate for Payer: Anthem Medicare Advantage |
$13,176.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,176.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,176.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,176.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$29,180.94
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,176.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33,551.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,176.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,176.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,176.50
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,176.50
|
| Rate for Payer: NAPHCARE Commercial |
$19,764.75
|
| Rate for Payer: Quartz Medicare Advantage |
$13,176.50
|
| Rate for Payer: The Alliance Commercial |
$46,076.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,176.50
|
| Rate for Payer: United Healthcare PPO |
$26,120.07
|
| Rate for Payer: Wellcare Medicare |
$13,176.50
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,917.04
|
|
|
Service Code
|
MSDRG 700
|
| Min. Negotiated Rate |
$5,790.18 |
| Max. Negotiated Rate |
$19,917.04 |
| Rate for Payer: Aetna Managed Medicare |
$5,790.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15,053.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,538.05
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,961.90
|
| Rate for Payer: Anthem Medicare Advantage |
$5,790.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,790.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,790.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,790.18
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,168.72
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,790.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,364.32
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,790.18
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,790.18
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,790.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,790.18
|
| Rate for Payer: NAPHCARE Commercial |
$8,685.27
|
| Rate for Payer: Quartz Medicare Advantage |
$5,790.18
|
| Rate for Payer: The Alliance Commercial |
$19,917.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,790.18
|
| Rate for Payer: United Healthcare PPO |
$11,182.81
|
| Rate for Payer: Wellcare Medicare |
$5,790.18
|
|
|
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC
|
Facility
|
IP
|
$66,200.16
|
|
|
Service Code
|
MSDRG 674
|
| Min. Negotiated Rate |
$18,416.23 |
| Max. Negotiated Rate |
$66,200.16 |
| Rate for Payer: Aetna Managed Medicare |
$18,416.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$51,026.38
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$39,111.31
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$37,158.30
|
| Rate for Payer: Anthem Medicare Advantage |
$18,416.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,416.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,416.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,416.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41,249.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,416.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,311.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,416.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,416.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,416.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,416.23
|
| Rate for Payer: NAPHCARE Commercial |
$27,624.34
|
| Rate for Payer: Quartz Medicare Advantage |
$18,416.23
|
| Rate for Payer: The Alliance Commercial |
$66,200.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,416.23
|
| Rate for Payer: United Healthcare PPO |
$37,610.75
|
| Rate for Payer: Wellcare Medicare |
$18,416.23
|
|
|
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC
|
Facility
|
IP
|
$102,580.40
|
|
|
Service Code
|
MSDRG 673
|
| Min. Negotiated Rate |
$32,683.47 |
| Max. Negotiated Rate |
$102,580.40 |
| Rate for Payer: Aetna Managed Medicare |
$32,683.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$91,675.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$70,268.57
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$66,759.73
|
| Rate for Payer: Anthem Medicare Advantage |
$32,683.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$32,683.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$32,683.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$32,683.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$74,109.42
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$32,683.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74,995.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$32,683.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$32,683.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$32,683.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$32,683.47
|
| Rate for Payer: NAPHCARE Commercial |
$49,025.20
|
| Rate for Payer: Quartz Medicare Advantage |
$32,683.47
|
| Rate for Payer: The Alliance Commercial |
$102,580.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,683.47
|
| Rate for Payer: United Healthcare PPO |
$58,384.91
|
| Rate for Payer: Wellcare Medicare |
$32,683.47
|
|
|
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$44,198.96
|
|
|
Service Code
|
MSDRG 675
|
| Min. Negotiated Rate |
$13,076.95 |
| Max. Negotiated Rate |
$44,198.96 |
| Rate for Payer: Aetna Managed Medicare |
$13,076.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$35,814.03
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27,451.17
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$26,080.40
|
| Rate for Payer: Anthem Medicare Advantage |
$13,076.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,076.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,076.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,076.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28,951.64
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,076.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,174.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,076.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,076.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,076.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,076.95
|
| Rate for Payer: NAPHCARE Commercial |
$19,615.42
|
| Rate for Payer: Quartz Medicare Advantage |
$13,076.95
|
| Rate for Payer: The Alliance Commercial |
$44,198.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,076.95
|
| Rate for Payer: United Healthcare PPO |
$25,048.05
|
| Rate for Payer: Wellcare Medicare |
$13,076.95
|
|
|
OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES
|
Facility
|
IP
|
$37,528.37
|
|
|
Service Code
|
APR-DRG 4474
|
| Min. Negotiated Rate |
$33,335.04 |
| Max. Negotiated Rate |
$37,528.37 |
| Rate for Payer: Anthem Medicaid |
$35,935.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$35,935.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$35,935.48
|
| Rate for Payer: Dean Health Medicaid |
$35,935.48
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$33,335.04
|
| Rate for Payer: Managed Health Services Medicaid |
$37,528.37
|
| Rate for Payer: Molina Healthcare Medicaid |
$35,935.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$35,935.48
|
| Rate for Payer: United Healthcare Medicaid |
$35,935.48
|
|
|
OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES
|
Facility
|
IP
|
$21,482.36
|
|
|
Service Code
|
APR-DRG 4473
|
| Min. Negotiated Rate |
$19,081.97 |
| Max. Negotiated Rate |
$21,482.36 |
| Rate for Payer: Anthem Medicaid |
$20,570.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20,570.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20,570.54
|
| Rate for Payer: Dean Health Medicaid |
$20,570.54
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19,081.97
|
| Rate for Payer: Managed Health Services Medicaid |
$21,482.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$20,570.54
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20,570.54
|
| Rate for Payer: United Healthcare Medicaid |
$20,570.54
|
|
|
OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES
|
Facility
|
IP
|
$14,380.03
|
|
|
Service Code
|
APR-DRG 4472
|
| Min. Negotiated Rate |
$12,773.24 |
| Max. Negotiated Rate |
$14,380.03 |
| Rate for Payer: Anthem Medicaid |
$13,769.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$13,769.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13,769.67
|
| Rate for Payer: Dean Health Medicaid |
$13,769.67
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12,773.24
|
| Rate for Payer: Managed Health Services Medicaid |
$14,380.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,769.67
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13,769.67
|
| Rate for Payer: United Healthcare Medicaid |
$13,769.67
|
|
|
OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES
|
Facility
|
IP
|
$11,661.85
|
|
|
Service Code
|
APR-DRG 4471
|
| Min. Negotiated Rate |
$10,358.78 |
| Max. Negotiated Rate |
$11,661.85 |
| Rate for Payer: Anthem Medicaid |
$11,166.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$11,166.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11,166.87
|
| Rate for Payer: Dean Health Medicaid |
$11,166.87
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,358.78
|
| Rate for Payer: Managed Health Services Medicaid |
$11,661.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,166.87
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11,166.87
|
| Rate for Payer: United Healthcare Medicaid |
$11,166.87
|
|
|
OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES
|
Facility
|
IP
|
$22,008.46
|
|
|
Service Code
|
APR-DRG 4483
|
| 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 KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES
|
Facility
|
IP
|
$37,177.63
|
|
|
Service Code
|
APR-DRG 4484
|
| Min. Negotiated Rate |
$33,023.49 |
| Max. Negotiated Rate |
$37,177.63 |
| Rate for Payer: Anthem Medicaid |
$35,599.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$35,599.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$35,599.63
|
| Rate for Payer: Dean Health Medicaid |
$35,599.63
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$33,023.49
|
| Rate for Payer: Managed Health Services Medicaid |
$37,177.63
|
| Rate for Payer: Molina Healthcare Medicaid |
$35,599.63
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$35,599.63
|
| Rate for Payer: United Healthcare Medicaid |
$35,599.63
|
|
|
OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES
|
Facility
|
IP
|
$18,238.08
|
|
|
Service Code
|
APR-DRG 4482
|
| Min. Negotiated Rate |
$16,200.20 |
| Max. Negotiated Rate |
$18,238.08 |
| Rate for Payer: Anthem Medicaid |
$17,463.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,463.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,463.97
|
| Rate for Payer: Dean Health Medicaid |
$17,463.97
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,200.20
|
| Rate for Payer: Managed Health Services Medicaid |
$18,238.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,463.97
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,463.97
|
| Rate for Payer: United Healthcare Medicaid |
$17,463.97
|
|
|
OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES
|
Facility
|
IP
|
$12,187.95
|
|
|
Service Code
|
APR-DRG 4481
|
| Min. Negotiated Rate |
$10,826.10 |
| Max. Negotiated Rate |
$12,187.95 |
| Rate for Payer: Anthem Medicaid |
$11,670.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$11,670.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11,670.63
|
| Rate for Payer: Dean Health Medicaid |
$11,670.63
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,826.10
|
| Rate for Payer: Managed Health Services Medicaid |
$12,187.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,670.63
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11,670.63
|
| Rate for Payer: United Healthcare Medicaid |
$11,670.63
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$95,895.28
|
|
|
Service Code
|
MSDRG 271
|
| Min. Negotiated Rate |
$27,741.63 |
| Max. Negotiated Rate |
$95,895.28 |
| Rate for Payer: Aetna Managed Medicare |
$27,741.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$77,595.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$59,476.41
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$56,506.48
|
| Rate for Payer: Anthem Medicare Advantage |
$27,741.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27,741.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27,741.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$27,741.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$62,727.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$27,741.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$70,091.74
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$27,741.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27,741.63
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$27,741.63
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$27,741.63
|
| Rate for Payer: NAPHCARE Commercial |
$41,612.44
|
| Rate for Payer: Quartz Medicare Advantage |
$27,741.63
|
| Rate for Payer: The Alliance Commercial |
$95,895.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,741.63
|
| Rate for Payer: United Healthcare PPO |
$54,567.31
|
| Rate for Payer: Wellcare Medicare |
$27,741.63
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$140,153.52
|
|
|
Service Code
|
MSDRG 270
|
| Min. Negotiated Rate |
$40,913.72 |
| Max. Negotiated Rate |
$140,153.52 |
| Rate for Payer: Aetna Managed Medicare |
$40,913.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$115,124.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$88,242.11
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$83,835.76
|
| Rate for Payer: Anthem Medicare Advantage |
$40,913.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40,913.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40,913.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$40,913.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$93,065.38
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$40,913.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$102,553.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$40,913.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40,913.72
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$40,913.72
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$40,913.72
|
| Rate for Payer: NAPHCARE Commercial |
$61,370.59
|
| Rate for Payer: Quartz Medicare Advantage |
$40,913.72
|
| Rate for Payer: The Alliance Commercial |
$140,153.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40,913.72
|
| Rate for Payer: United Healthcare PPO |
$79,839.55
|
| Rate for Payer: Wellcare Medicare |
$40,913.72
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$67,784.08
|
|
|
Service Code
|
MSDRG 272
|
| Min. Negotiated Rate |
$20,058.17 |
| Max. Negotiated Rate |
$67,784.08 |
| Rate for Payer: Aetna Managed Medicare |
$20,058.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$55,704.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$42,696.98
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40,564.92
|
| Rate for Payer: Anthem Medicare Advantage |
$20,058.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20,058.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20,058.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20,058.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$45,030.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20,058.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49,473.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20,058.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20,058.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20,058.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20,058.17
|
| Rate for Payer: NAPHCARE Commercial |
$30,087.25
|
| Rate for Payer: Quartz Medicare Advantage |
$20,058.17
|
| Rate for Payer: The Alliance Commercial |
$67,784.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,058.17
|
| Rate for Payer: United Healthcare PPO |
$38,515.41
|
| Rate for Payer: Wellcare Medicare |
$20,058.17
|
|
|
OTHER MAJOR HEAD AND NECK PROCEDURES
|
Facility
|
IP
|
$36,651.54
|
|
|
Service Code
|
APR-DRG 0913
|
| Min. Negotiated Rate |
$32,556.18 |
| Max. Negotiated Rate |
$36,651.54 |
| Rate for Payer: Anthem Medicaid |
$35,095.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$35,095.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$35,095.87
|
| Rate for Payer: Dean Health Medicaid |
$35,095.87
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$32,556.18
|
| Rate for Payer: Managed Health Services Medicaid |
$36,651.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$35,095.87
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$35,095.87
|
| Rate for Payer: United Healthcare Medicaid |
$35,095.87
|
|
|
OTHER MAJOR HEAD AND NECK PROCEDURES
|
Facility
|
IP
|
$15,344.54
|
|
|
Service Code
|
APR-DRG 0911
|
| Min. Negotiated Rate |
$13,629.98 |
| Max. Negotiated Rate |
$15,344.54 |
| Rate for Payer: Anthem Medicaid |
$14,693.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$14,693.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14,693.25
|
| Rate for Payer: Dean Health Medicaid |
$14,693.25
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$13,629.98
|
| Rate for Payer: Managed Health Services Medicaid |
$15,344.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,693.25
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14,693.25
|
| Rate for Payer: United Healthcare Medicaid |
$14,693.25
|
|
|
OTHER MAJOR HEAD AND NECK PROCEDURES
|
Facility
|
IP
|
$54,889.62
|
|
|
Service Code
|
APR-DRG 0914
|
| Min. Negotiated Rate |
$48,756.39 |
| Max. Negotiated Rate |
$54,889.62 |
| Rate for Payer: Anthem Medicaid |
$52,559.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$52,559.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$52,559.84
|
| Rate for Payer: Dean Health Medicaid |
$52,559.84
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$48,756.39
|
| Rate for Payer: Managed Health Services Medicaid |
$54,889.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$52,559.84
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$52,559.84
|
| Rate for Payer: United Healthcare Medicaid |
$52,559.84
|
|
|
OTHER MAJOR HEAD AND NECK PROCEDURES
|
Facility
|
IP
|
$24,551.27
|
|
|
Service Code
|
APR-DRG 0912
|
| Min. Negotiated Rate |
$21,807.97 |
| Max. Negotiated Rate |
$24,551.27 |
| Rate for Payer: Anthem Medicaid |
$23,509.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$23,509.19
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$23,509.19
|
| Rate for Payer: Dean Health Medicaid |
$23,509.19
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$21,807.97
|
| Rate for Payer: Managed Health Services Medicaid |
$24,551.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$23,509.19
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$23,509.19
|
| Rate for Payer: United Healthcare Medicaid |
$23,509.19
|
|
|
OTHER MAJOR LIVER DIAGNOSES
|
Facility
|
OP
|
$91.72
|
|
|
Service Code
|
EAPG 00641
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$91.72 |
| Rate for Payer: Anthem Medicaid |
$88.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$88.19
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$88.19
|
| Rate for Payer: Dean Health Medicaid |
$88.19
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$88.19
|
| Rate for Payer: Managed Health Services Medicaid |
$91.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$88.19
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$88.19
|
| Rate for Payer: United Healthcare Medicaid |
$88.19
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$13,152.47
|
|
|
Service Code
|
APR-DRG 4842
|
| Min. Negotiated Rate |
$11,682.84 |
| Max. Negotiated Rate |
$13,152.47 |
| Rate for Payer: Anthem Medicaid |
$12,594.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,594.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,594.21
|
| Rate for Payer: Dean Health Medicaid |
$12,594.21
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,682.84
|
| Rate for Payer: Managed Health Services Medicaid |
$13,152.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,594.21
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,594.21
|
| Rate for Payer: United Healthcare Medicaid |
$12,594.21
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$38,492.88
|
|
|
Service Code
|
APR-DRG 4844
|
| Min. Negotiated Rate |
$34,191.78 |
| Max. Negotiated Rate |
$38,492.88 |
| Rate for Payer: Anthem Medicaid |
$36,859.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$36,859.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$36,859.05
|
| Rate for Payer: Dean Health Medicaid |
$36,859.05
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$34,191.78
|
| Rate for Payer: Managed Health Services Medicaid |
$38,492.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$36,859.05
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$36,859.05
|
| Rate for Payer: United Healthcare Medicaid |
$36,859.05
|
|
