|
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
|
$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
|
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
|
$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
|
OP
|
$39.46
|
|
|
Service Code
|
EAPG 00852
|
| Min. Negotiated Rate |
$37.95 |
| Max. Negotiated Rate |
$39.46 |
| Rate for Payer: Anthem Medicaid |
$37.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$37.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$37.95
|
| Rate for Payer: Dean Health Medicaid |
$37.95
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$37.95
|
| Rate for Payer: Managed Health Services Medicaid |
$39.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$37.95
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$37.95
|
| Rate for Payer: United Healthcare Medicaid |
$37.95
|
|
|
OTHER CRANIOTOMY PROCEDURES INCLUDING CRANIOPLASTY
|
Facility
|
OP
|
$1,317.53
|
|
|
Service Code
|
EAPG 00267
|
| Min. Negotiated Rate |
$1,266.85 |
| Max. Negotiated Rate |
$1,317.53 |
| Rate for Payer: Anthem Medicaid |
$1,266.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$1,266.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,266.85
|
| Rate for Payer: Dean Health Medicaid |
$1,266.85
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$1,266.85
|
| Rate for Payer: Managed Health Services Medicaid |
$1,317.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,266.85
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$1,266.85
|
| Rate for Payer: United Healthcare Medicaid |
$1,266.85
|
|
|
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
|
$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 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
|
$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 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
|
$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
|
$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
|
|
|
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
|
$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
|
$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
|
$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
|
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 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
|
|
