|
OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES
|
Facility
|
IP
|
$8,329.89
|
|
|
Service Code
|
APR-DRG 0981
|
| 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, THROAT, CRANIOFACIAL, AND NECK PROCEDURES
|
Facility
|
IP
|
$34,021.04
|
|
|
Service Code
|
APR-DRG 0984
|
| Min. Negotiated Rate |
$30,219.61 |
| Max. Negotiated Rate |
$34,021.04 |
| Rate for Payer: Anthem Medicaid |
$32,577.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$32,577.02
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$32,577.02
|
| Rate for Payer: Dean Health Medicaid |
$32,577.02
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$30,219.61
|
| Rate for Payer: Managed Health Services Medicaid |
$34,021.04
|
| Rate for Payer: Molina Healthcare Medicaid |
$32,577.02
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$32,577.02
|
| Rate for Payer: United Healthcare Medicaid |
$32,577.02
|
|
|
OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES
|
Facility
|
IP
|
$13,853.93
|
|
|
Service Code
|
APR-DRG 0982
|
| Min. Negotiated Rate |
$12,305.92 |
| Max. Negotiated Rate |
$13,853.93 |
| Rate for Payer: Anthem Medicaid |
$13,265.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$13,265.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13,265.90
|
| Rate for Payer: Dean Health Medicaid |
$13,265.90
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12,305.92
|
| Rate for Payer: Managed Health Services Medicaid |
$13,853.93
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,265.90
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13,265.90
|
| Rate for Payer: United Healthcare Medicaid |
$13,265.90
|
|
|
OTHER ENDOCRINE DISORDERS
|
Facility
|
IP
|
$18,588.82
|
|
|
Service Code
|
APR-DRG 4244
|
| Min. Negotiated Rate |
$16,511.75 |
| Max. Negotiated Rate |
$18,588.82 |
| Rate for Payer: Anthem Medicaid |
$17,799.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,799.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,799.82
|
| Rate for Payer: Dean Health Medicaid |
$17,799.82
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,511.75
|
| Rate for Payer: Managed Health Services Medicaid |
$18,588.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,799.82
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,799.82
|
| Rate for Payer: United Healthcare Medicaid |
$17,799.82
|
|
|
OTHER ENDOCRINE DISORDERS
|
Facility
|
IP
|
$5,260.99
|
|
|
Service Code
|
APR-DRG 4241
|
| Min. Negotiated Rate |
$4,673.14 |
| Max. Negotiated Rate |
$5,260.99 |
| Rate for Payer: Anthem Medicaid |
$5,037.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$5,037.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,037.68
|
| Rate for Payer: Dean Health Medicaid |
$5,037.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,673.14
|
| Rate for Payer: Managed Health Services Medicaid |
$5,260.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,037.68
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5,037.68
|
| Rate for Payer: United Healthcare Medicaid |
$5,037.68
|
|
|
OTHER ENDOCRINE DISORDERS
|
Facility
|
IP
|
$7,628.43
|
|
|
Service Code
|
APR-DRG 4242
|
| Min. Negotiated Rate |
$6,776.05 |
| Max. Negotiated Rate |
$7,628.43 |
| Rate for Payer: Anthem Medicaid |
$7,304.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,304.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,304.64
|
| Rate for Payer: Dean Health Medicaid |
$7,304.64
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,776.05
|
| Rate for Payer: Managed Health Services Medicaid |
$7,628.43
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,304.64
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,304.64
|
| Rate for Payer: United Healthcare Medicaid |
$7,304.64
|
|
|
OTHER ENDOCRINE DISORDERS
|
Facility
|
IP
|
$11,486.49
|
|
|
Service Code
|
APR-DRG 4243
|
| Min. Negotiated Rate |
$10,203.01 |
| Max. Negotiated Rate |
$11,486.49 |
| Rate for Payer: Anthem Medicaid |
$10,998.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,998.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,998.94
|
| Rate for Payer: Dean Health Medicaid |
$10,998.94
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,203.01
|
| Rate for Payer: Managed Health Services Medicaid |
$11,486.49
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,998.94
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,998.94
|
| Rate for Payer: United Healthcare Medicaid |
$10,998.94
|
|
|
OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$62,898.16
|
|
|
Service Code
|
MSDRG 629
|
| Min. Negotiated Rate |
$17,192.47 |
| Max. Negotiated Rate |
$62,898.16 |
| Rate for Payer: Aetna Managed Medicare |
$17,192.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$47,539.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$36,438.77
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$34,619.21
|
| Rate for Payer: Anthem Medicare Advantage |
$17,192.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17,192.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17,192.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17,192.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$38,430.50
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17,192.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$45,889.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17,192.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17,192.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17,192.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17,192.47
|
| Rate for Payer: NAPHCARE Commercial |
$25,788.70
|
| Rate for Payer: Quartz Medicare Advantage |
$17,192.47
|
| Rate for Payer: The Alliance Commercial |
$62,898.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,192.47
|
| Rate for Payer: United Healthcare PPO |
$35,725.63
|
| Rate for Payer: Wellcare Medicare |
$17,192.47
|
|
|
OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$111,332.00
|
|
|
Service Code
|
MSDRG 628
|
| Min. Negotiated Rate |
$29,047.34 |
| Max. Negotiated Rate |
$111,332.00 |
| Rate for Payer: Aetna Managed Medicare |
$29,047.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$81,315.79
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$62,327.90
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$59,215.57
|
| Rate for Payer: Anthem Medicare Advantage |
$29,047.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$29,047.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$29,047.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$29,047.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$65,734.71
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$29,047.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$81,414.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29,047.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$29,047.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$29,047.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$29,047.34
|
| Rate for Payer: NAPHCARE Commercial |
$43,571.00
|
| Rate for Payer: Quartz Medicare Advantage |
$29,047.34
|
| Rate for Payer: The Alliance Commercial |
$111,332.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,047.34
|
| Rate for Payer: United Healthcare PPO |
$63,381.88
|
| Rate for Payer: Wellcare Medicare |
$29,047.34
|
|
|
OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$38,939.68
|
|
|
Service Code
|
MSDRG 630
|
| Min. Negotiated Rate |
$11,683.91 |
| Max. Negotiated Rate |
$38,939.68 |
| Rate for Payer: Aetna Managed Medicare |
$11,683.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31,845.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24,409.03
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23,190.17
|
| Rate for Payer: Anthem Medicare Advantage |
$11,683.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11,683.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11,683.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11,683.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25,743.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11,683.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28,316.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11,683.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11,683.91
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11,683.91
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11,683.91
|
| Rate for Payer: NAPHCARE Commercial |
$17,525.87
|
| Rate for Payer: Quartz Medicare Advantage |
$11,683.91
|
| Rate for Payer: The Alliance Commercial |
$38,939.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,683.91
|
| Rate for Payer: United Healthcare PPO |
$22,045.12
|
| Rate for Payer: Wellcare Medicare |
$11,683.91
|
|
|
OTHER ENDOCRINE SYSTEM DIAGNOSES
|
Facility
|
OP
|
$30.78
|
|
|
Service Code
|
EAPG 00692
|
| Min. Negotiated Rate |
$29.59 |
| Max. Negotiated Rate |
$30.78 |
| Rate for Payer: Anthem Medicaid |
$29.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$29.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.59
|
| Rate for Payer: Dean Health Medicaid |
$29.59
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$29.59
|
| Rate for Payer: Managed Health Services Medicaid |
$30.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$29.59
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$29.59
|
| Rate for Payer: United Healthcare Medicaid |
$29.59
|
|
|
OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC
|
Facility
|
IP
|
$120,937.44
|
|
|
Service Code
|
MSDRG 319
|
| Min. Negotiated Rate |
$34,684.55 |
| Max. Negotiated Rate |
$120,937.44 |
| Rate for Payer: Aetna Managed Medicare |
$34,684.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$97,376.91
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$74,638.61
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$70,911.55
|
| Rate for Payer: Anthem Medicare Advantage |
$34,684.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34,684.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34,684.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$34,684.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$78,718.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$34,684.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$88,459.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$34,684.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34,684.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$34,684.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$34,684.55
|
| Rate for Payer: NAPHCARE Commercial |
$52,026.83
|
| Rate for Payer: Quartz Medicare Advantage |
$34,684.55
|
| Rate for Payer: The Alliance Commercial |
$120,937.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34,684.55
|
| Rate for Payer: United Healthcare PPO |
$68,866.72
|
| Rate for Payer: Wellcare Medicare |
$34,684.55
|
|
|
OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$61,881.04
|
|
|
Service Code
|
MSDRG 320
|
| Min. Negotiated Rate |
$18,927.04 |
| Max. Negotiated Rate |
$61,881.04 |
| Rate for Payer: Aetna Managed Medicare |
$18,927.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$52,481.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$40,226.81
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$38,218.10
|
| Rate for Payer: Anthem Medicare Advantage |
$18,927.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,927.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,927.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,927.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$42,425.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,927.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$45,143.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,927.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,927.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,927.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,927.04
|
| Rate for Payer: NAPHCARE Commercial |
$28,390.56
|
| Rate for Payer: Quartz Medicare Advantage |
$18,927.04
|
| Rate for Payer: The Alliance Commercial |
$61,881.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,927.04
|
| Rate for Payer: United Healthcare PPO |
$35,144.63
|
| Rate for Payer: Wellcare Medicare |
$18,927.04
|
|
|
OTHER ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$5,611.72
|
|
|
Service Code
|
APR-DRG 2431
|
| Min. Negotiated Rate |
$4,984.68 |
| Max. Negotiated Rate |
$5,611.72 |
| Rate for Payer: Anthem Medicaid |
$5,373.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$5,373.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,373.53
|
| Rate for Payer: Dean Health Medicaid |
$5,373.53
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,984.68
|
| Rate for Payer: Managed Health Services Medicaid |
$5,611.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,373.53
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5,373.53
|
| Rate for Payer: United Healthcare Medicaid |
$5,373.53
|
|
|
OTHER ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$7,277.70
|
|
|
Service Code
|
APR-DRG 2432
|
| 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 ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$10,258.92
|
|
|
Service Code
|
APR-DRG 2433
|
| Min. Negotiated Rate |
$9,112.62 |
| Max. Negotiated Rate |
$10,258.92 |
| Rate for Payer: Anthem Medicaid |
$9,823.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$9,823.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9,823.48
|
| Rate for Payer: Dean Health Medicaid |
$9,823.48
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,112.62
|
| Rate for Payer: Managed Health Services Medicaid |
$10,258.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,823.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$9,823.48
|
| Rate for Payer: United Healthcare Medicaid |
$9,823.48
|
|
|
OTHER ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$18,939.55
|
|
|
Service Code
|
APR-DRG 2434
|
| Min. Negotiated Rate |
$16,823.29 |
| Max. Negotiated Rate |
$18,939.55 |
| Rate for Payer: Anthem Medicaid |
$18,135.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$18,135.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18,135.66
|
| Rate for Payer: Dean Health Medicaid |
$18,135.66
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,823.29
|
| Rate for Payer: Managed Health Services Medicaid |
$18,939.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$18,135.66
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18,135.66
|
| Rate for Payer: United Healthcare Medicaid |
$18,135.66
|
|
|
OTHER EYE INFECTION DIAGNOSES
|
Facility
|
OP
|
$21.75
|
|
|
Service Code
|
EAPG 00557
|
| Min. Negotiated Rate |
$20.91 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Anthem Medicaid |
$20.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20.91
|
| Rate for Payer: Dean Health Medicaid |
$20.91
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$20.91
|
| Rate for Payer: Managed Health Services Medicaid |
$21.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$20.91
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20.91
|
| Rate for Payer: United Healthcare Medicaid |
$20.91
|
|
|
OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$16,646.24
|
|
|
Service Code
|
MSDRG 951
|
| Min. Negotiated Rate |
$4,764.73 |
| Max. Negotiated Rate |
$16,646.24 |
| Rate for Payer: Aetna Managed Medicare |
$4,764.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12,131.48
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9,298.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8,834.35
|
| Rate for Payer: Anthem Medicare Advantage |
$4,764.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4,764.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4,764.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4,764.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,806.94
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4,764.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,965.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4,764.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4,764.73
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4,764.73
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4,764.73
|
| Rate for Payer: NAPHCARE Commercial |
$7,147.09
|
| Rate for Payer: Quartz Medicare Advantage |
$4,764.73
|
| Rate for Payer: The Alliance Commercial |
$16,646.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,764.73
|
| Rate for Payer: United Healthcare PPO |
$9,315.06
|
| Rate for Payer: Wellcare Medicare |
$4,764.73
|
|
|
OTHER FEMALE REPRODUCTIVE SYSTEM AND MENSTRUAL DIAGNOSES
|
Facility
|
OP
|
$29.83
|
|
|
Service Code
|
EAPG 00752
|
| Min. Negotiated Rate |
$28.68 |
| Max. Negotiated Rate |
$29.83 |
| Rate for Payer: Anthem Medicaid |
$28.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$28.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.68
|
| Rate for Payer: Dean Health Medicaid |
$28.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$28.68
|
| Rate for Payer: Managed Health Services Medicaid |
$29.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$28.68
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$28.68
|
| Rate for Payer: United Healthcare Medicaid |
$28.68
|
|
|
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$13,415.51
|
|
|
Service Code
|
APR-DRG 5182
|
| Min. Negotiated Rate |
$11,916.50 |
| Max. Negotiated Rate |
$13,415.51 |
| Rate for Payer: Anthem Medicaid |
$12,846.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,846.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,846.09
|
| Rate for Payer: Dean Health Medicaid |
$12,846.09
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,916.50
|
| Rate for Payer: Managed Health Services Medicaid |
$13,415.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,846.09
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,846.09
|
| Rate for Payer: United Healthcare Medicaid |
$12,846.09
|
|
|
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$8,066.85
|
|
|
Service Code
|
APR-DRG 5181
|
| Min. Negotiated Rate |
$7,165.48 |
| Max. Negotiated Rate |
$8,066.85 |
| Rate for Payer: Anthem Medicaid |
$7,724.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,724.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,724.45
|
| Rate for Payer: Dean Health Medicaid |
$7,724.45
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,165.48
|
| Rate for Payer: Managed Health Services Medicaid |
$8,066.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,724.45
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,724.45
|
| Rate for Payer: United Healthcare Medicaid |
$7,724.45
|
|
|
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$21,219.31
|
|
|
Service Code
|
APR-DRG 5183
|
| Min. Negotiated Rate |
$18,848.32 |
| Max. Negotiated Rate |
$21,219.31 |
| Rate for Payer: Anthem Medicaid |
$20,318.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20,318.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20,318.66
|
| Rate for Payer: Dean Health Medicaid |
$20,318.66
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,848.32
|
| Rate for Payer: Managed Health Services Medicaid |
$21,219.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$20,318.66
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20,318.66
|
| Rate for Payer: United Healthcare Medicaid |
$20,318.66
|
|
|
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$35,160.92
|
|
|
Service Code
|
APR-DRG 5184
|
| Min. Negotiated Rate |
$31,232.13 |
| Max. Negotiated Rate |
$35,160.92 |
| Rate for Payer: Anthem Medicaid |
$33,668.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$33,668.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$33,668.52
|
| Rate for Payer: Dean Health Medicaid |
$33,668.52
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$31,232.13
|
| Rate for Payer: Managed Health Services Medicaid |
$35,160.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$33,668.52
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$33,668.52
|
| Rate for Payer: United Healthcare Medicaid |
$33,668.52
|
|
|
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$69,932.72
|
|
|
Service Code
|
MSDRG 749
|
| Min. Negotiated Rate |
$20,169.97 |
| Max. Negotiated Rate |
$69,932.72 |
| Rate for Payer: Aetna Managed Medicare |
$20,169.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56,022.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$42,941.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40,796.90
|
| Rate for Payer: Anthem Medicare Advantage |
$20,169.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20,169.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20,169.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20,169.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$45,288.30
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20,169.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51,048.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20,169.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20,169.97
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20,169.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20,169.97
|
| Rate for Payer: NAPHCARE Commercial |
$30,254.95
|
| Rate for Payer: Quartz Medicare Advantage |
$20,169.97
|
| Rate for Payer: The Alliance Commercial |
$69,932.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,169.97
|
| Rate for Payer: United Healthcare PPO |
$39,742.15
|
| Rate for Payer: Wellcare Medicare |
$20,169.97
|
|
