|
OTHER INFECTIOUS AND PARASITIC DISEASES
|
Facility
|
OP
|
$34.16
|
|
|
Service Code
|
EAPG 00809
|
| Min. Negotiated Rate |
$32.85 |
| Max. Negotiated Rate |
$34.16 |
| Rate for Payer: Anthem Medicaid |
$32.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$32.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$32.85
|
| Rate for Payer: Dean Health Medicaid |
$32.85
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$32.85
|
| Rate for Payer: Managed Health Services Medicaid |
$34.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$32.85
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$32.85
|
| Rate for Payer: United Healthcare Medicaid |
$32.85
|
|
|
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC
|
Facility
|
IP
|
$30,346.16
|
|
|
Service Code
|
MSDRG 868
|
| Min. Negotiated Rate |
$8,403.15 |
| Max. Negotiated Rate |
$30,346.16 |
| Rate for Payer: Aetna Managed Medicare |
$8,403.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22,497.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17,244.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,383.27
|
| Rate for Payer: Anthem Medicare Advantage |
$8,403.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,403.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,403.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,403.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,186.93
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,403.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22,013.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,403.15
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,403.15
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,403.15
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,403.15
|
| Rate for Payer: NAPHCARE Commercial |
$12,604.72
|
| Rate for Payer: Quartz Medicare Advantage |
$8,403.15
|
| Rate for Payer: The Alliance Commercial |
$30,346.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,403.15
|
| Rate for Payer: United Healthcare PPO |
$17,138.14
|
| Rate for Payer: Wellcare Medicare |
$8,403.15
|
|
|
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC
|
Facility
|
IP
|
$58,183.84
|
|
|
Service Code
|
MSDRG 867
|
| Min. Negotiated Rate |
$16,536.90 |
| Max. Negotiated Rate |
$58,183.84 |
| Rate for Payer: Aetna Managed Medicare |
$16,536.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$45,671.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35,007.18
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33,259.11
|
| Rate for Payer: Anthem Medicare Advantage |
$16,536.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16,536.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16,536.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16,536.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36,920.66
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16,536.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42,431.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16,536.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16,536.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16,536.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16,536.90
|
| Rate for Payer: NAPHCARE Commercial |
$24,805.36
|
| Rate for Payer: Quartz Medicare Advantage |
$16,536.90
|
| Rate for Payer: The Alliance Commercial |
$58,183.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,536.90
|
| Rate for Payer: United Healthcare PPO |
$33,033.74
|
| Rate for Payer: Wellcare Medicare |
$16,536.90
|
|
|
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,430.32
|
|
|
Service Code
|
MSDRG 869
|
| Min. Negotiated Rate |
$6,094.97 |
| Max. Negotiated Rate |
$19,430.32 |
| Rate for Payer: Aetna Managed Medicare |
$6,094.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15,921.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$12,203.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11,594.29
|
| Rate for Payer: Anthem Medicare Advantage |
$6,094.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,094.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,094.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,094.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,870.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,094.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,007.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,094.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,094.97
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,094.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,094.97
|
| Rate for Payer: NAPHCARE Commercial |
$9,142.46
|
| Rate for Payer: Quartz Medicare Advantage |
$6,094.97
|
| Rate for Payer: The Alliance Commercial |
$19,430.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,094.97
|
| Rate for Payer: United Healthcare PPO |
$10,904.94
|
| Rate for Payer: Wellcare Medicare |
$6,094.97
|
|
|
OTHER INJURIES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE
|
Facility
|
OP
|
$30.76
|
|
|
Service Code
|
EAPG 00652
|
| Min. Negotiated Rate |
$29.58 |
| Max. Negotiated Rate |
$30.76 |
| Rate for Payer: Anthem Medicaid |
$29.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$29.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.58
|
| Rate for Payer: Dean Health Medicaid |
$29.58
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$29.58
|
| Rate for Payer: Managed Health Services Medicaid |
$30.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$29.58
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$29.58
|
| Rate for Payer: United Healthcare Medicaid |
$29.58
|
|
|
OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES
|
Facility
|
IP
|
$4,033.42
|
|
|
Service Code
|
APR-DRG 8151
|
| Min. Negotiated Rate |
$3,582.74 |
| Max. Negotiated Rate |
$4,033.42 |
| Rate for Payer: Anthem Medicaid |
$3,862.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$3,862.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,862.22
|
| Rate for Payer: Dean Health Medicaid |
$3,862.22
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3,582.74
|
| Rate for Payer: Managed Health Services Medicaid |
$4,033.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,862.22
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$3,862.22
|
| Rate for Payer: United Healthcare Medicaid |
$3,862.22
|
|
|
OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES
|
Facility
|
IP
|
$10,258.92
|
|
|
Service Code
|
APR-DRG 8153
|
| 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 INJURY, POISONING AND TOXIC EFFECT DIAGNOSES
|
Facility
|
IP
|
$21,745.41
|
|
|
Service Code
|
APR-DRG 8154
|
| Min. Negotiated Rate |
$19,315.63 |
| Max. Negotiated Rate |
$21,745.41 |
| Rate for Payer: Anthem Medicaid |
$20,822.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20,822.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20,822.43
|
| Rate for Payer: Dean Health Medicaid |
$20,822.43
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19,315.63
|
| Rate for Payer: Managed Health Services Medicaid |
$21,745.41
|
| Rate for Payer: Molina Healthcare Medicaid |
$20,822.43
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20,822.43
|
| Rate for Payer: United Healthcare Medicaid |
$20,822.43
|
|
|
OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES
|
Facility
|
OP
|
$36.88
|
|
|
Service Code
|
EAPG 00853
|
| Min. Negotiated Rate |
$35.46 |
| Max. Negotiated Rate |
$36.88 |
| Rate for Payer: Anthem Medicaid |
$35.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$35.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$35.46
|
| Rate for Payer: Dean Health Medicaid |
$35.46
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$35.46
|
| Rate for Payer: Managed Health Services Medicaid |
$36.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$35.46
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$35.46
|
| Rate for Payer: United Healthcare Medicaid |
$35.46
|
|
|
OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES
|
Facility
|
IP
|
$6,137.82
|
|
|
Service Code
|
APR-DRG 8152
|
| Min. Negotiated Rate |
$5,451.99 |
| Max. Negotiated Rate |
$6,137.82 |
| Rate for Payer: Anthem Medicaid |
$5,877.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$5,877.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,877.30
|
| Rate for Payer: Dean Health Medicaid |
$5,877.30
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,451.99
|
| Rate for Payer: Managed Health Services Medicaid |
$6,137.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,877.30
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5,877.30
|
| Rate for Payer: United Healthcare Medicaid |
$5,877.30
|
|
|
OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC
|
Facility
|
IP
|
$48,578.40
|
|
|
Service Code
|
MSDRG 922
|
| Min. Negotiated Rate |
$13,904.03 |
| Max. Negotiated Rate |
$48,578.40 |
| Rate for Payer: Aetna Managed Medicare |
$13,904.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$38,170.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29,257.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27,796.43
|
| Rate for Payer: Anthem Medicare Advantage |
$13,904.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,904.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,904.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,904.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30,856.58
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,904.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35,386.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,904.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,904.03
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,904.03
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,904.03
|
| Rate for Payer: NAPHCARE Commercial |
$20,856.05
|
| Rate for Payer: Quartz Medicare Advantage |
$13,904.03
|
| Rate for Payer: The Alliance Commercial |
$48,578.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,904.03
|
| Rate for Payer: United Healthcare PPO |
$27,548.90
|
| Rate for Payer: Wellcare Medicare |
$13,904.03
|
|
|
OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC
|
Facility
|
IP
|
$28,297.36
|
|
|
Service Code
|
MSDRG 923
|
| Min. Negotiated Rate |
$10,718.72 |
| Max. Negotiated Rate |
$28,297.36 |
| Rate for Payer: Aetna Managed Medicare |
$10,718.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22,205.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17,020.26
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,170.36
|
| Rate for Payer: Anthem Medicare Advantage |
$10,718.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,718.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,718.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,718.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17,950.58
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,718.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,511.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,718.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,718.72
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,718.72
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,718.72
|
| Rate for Payer: NAPHCARE Commercial |
$16,078.08
|
| Rate for Payer: Quartz Medicare Advantage |
$10,718.72
|
| Rate for Payer: The Alliance Commercial |
$28,297.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,718.72
|
| Rate for Payer: United Healthcare PPO |
$15,968.22
|
| Rate for Payer: Wellcare Medicare |
$10,718.72
|
|
|
OTHER INTRA-ABDOMINAL AND INTRAPERITONEAL SURGICAL PROCEDURES
|
Facility
|
OP
|
$812.77
|
|
|
Service Code
|
EAPG 00108
|
| Min. Negotiated Rate |
$781.51 |
| Max. Negotiated Rate |
$812.77 |
| Rate for Payer: Anthem Medicaid |
$781.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$781.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$781.51
|
| Rate for Payer: Dean Health Medicaid |
$781.51
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$781.51
|
| Rate for Payer: Managed Health Services Medicaid |
$812.77
|
| Rate for Payer: Molina Healthcare Medicaid |
$781.51
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$781.51
|
| Rate for Payer: United Healthcare Medicaid |
$781.51
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS
|
Facility
|
IP
|
$6,313.18
|
|
|
Service Code
|
APR-DRG 4682
|
| Min. Negotiated Rate |
$5,607.76 |
| Max. Negotiated Rate |
$6,313.18 |
| Rate for Payer: Anthem Medicaid |
$6,045.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,045.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,045.22
|
| Rate for Payer: Dean Health Medicaid |
$6,045.22
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,607.76
|
| Rate for Payer: Managed Health Services Medicaid |
$6,313.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,045.22
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,045.22
|
| Rate for Payer: United Healthcare Medicaid |
$6,045.22
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS
|
Facility
|
IP
|
$17,361.25
|
|
|
Service Code
|
APR-DRG 4684
|
| Min. Negotiated Rate |
$15,421.35 |
| Max. Negotiated Rate |
$17,361.25 |
| Rate for Payer: Anthem Medicaid |
$16,624.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$16,624.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16,624.36
|
| Rate for Payer: Dean Health Medicaid |
$16,624.36
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15,421.35
|
| Rate for Payer: Managed Health Services Medicaid |
$17,361.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,624.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16,624.36
|
| Rate for Payer: United Healthcare Medicaid |
$16,624.36
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS
|
Facility
|
IP
|
$4,910.25
|
|
|
Service Code
|
APR-DRG 4681
|
| Min. Negotiated Rate |
$4,361.59 |
| Max. Negotiated Rate |
$4,910.25 |
| Rate for Payer: Anthem Medicaid |
$4,701.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,701.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,701.84
|
| Rate for Payer: Dean Health Medicaid |
$4,701.84
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,361.59
|
| Rate for Payer: Managed Health Services Medicaid |
$4,910.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,701.84
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,701.84
|
| Rate for Payer: United Healthcare Medicaid |
$4,701.84
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS
|
Facility
|
IP
|
$9,820.51
|
|
|
Service Code
|
APR-DRG 4683
|
| Min. Negotiated Rate |
$8,723.19 |
| Max. Negotiated Rate |
$9,820.51 |
| Rate for Payer: Anthem Medicaid |
$9,403.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$9,403.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9,403.68
|
| Rate for Payer: Dean Health Medicaid |
$9,403.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8,723.19
|
| Rate for Payer: Managed Health Services Medicaid |
$9,820.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,403.68
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$9,403.68
|
| Rate for Payer: United Healthcare Medicaid |
$9,403.68
|
|
|
OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS
|
Facility
|
OP
|
$34.98
|
|
|
Service Code
|
EAPG 00726
|
| Min. Negotiated Rate |
$33.64 |
| Max. Negotiated Rate |
$34.98 |
| Rate for Payer: Anthem Medicaid |
$33.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$33.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$33.64
|
| Rate for Payer: Dean Health Medicaid |
$33.64
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$33.64
|
| Rate for Payer: Managed Health Services Medicaid |
$34.98
|
| Rate for Payer: Molina Healthcare Medicaid |
$33.64
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$33.64
|
| Rate for Payer: United Healthcare Medicaid |
$33.64
|
|
|
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
|
$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
|
|
