|
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 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
|
$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 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
|
$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
|
$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
|
$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 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
|
$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
|
$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 LIVER DIAGNOSES
|
Facility
|
OP
|
$36.25
|
|
|
Service Code
|
EAPG 00641
|
| Min. Negotiated Rate |
$34.86 |
| Max. Negotiated Rate |
$36.25 |
| Rate for Payer: Anthem Medicaid |
$34.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$34.86
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$34.86
|
| Rate for Payer: Dean Health Medicaid |
$34.86
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$34.86
|
| Rate for Payer: Managed Health Services Medicaid |
$36.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$34.86
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$34.86
|
| Rate for Payer: United Healthcare Medicaid |
$34.86
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$10,697.34
|
|
|
Service Code
|
APR-DRG 4841
|
| Min. Negotiated Rate |
$9,502.04 |
| Max. Negotiated Rate |
$10,697.34 |
| Rate for Payer: Anthem Medicaid |
$10,243.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,243.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,243.29
|
| Rate for Payer: Dean Health Medicaid |
$10,243.29
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,502.04
|
| Rate for Payer: Managed Health Services Medicaid |
$10,697.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,243.29
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,243.29
|
| Rate for Payer: United Healthcare Medicaid |
$10,243.29
|
|
|
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
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$21,043.94
|
|
|
Service Code
|
APR-DRG 4843
|
| Min. Negotiated Rate |
$18,692.54 |
| Max. Negotiated Rate |
$21,043.94 |
| Rate for Payer: Anthem Medicaid |
$20,150.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20,150.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20,150.74
|
| Rate for Payer: Dean Health Medicaid |
$20,150.74
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,692.54
|
| Rate for Payer: Managed Health Services Medicaid |
$21,043.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$20,150.74
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20,150.74
|
| Rate for Payer: United Healthcare Medicaid |
$20,150.74
|
|
|
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 DIAGNOSES
|
Facility
|
OP
|
$33.72
|
|
|
Service Code
|
EAPG 00741
|
| Min. Negotiated Rate |
$32.43 |
| Max. Negotiated Rate |
$33.72 |
| Rate for Payer: Anthem Medicaid |
$32.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$32.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$32.43
|
| Rate for Payer: Dean Health Medicaid |
$32.43
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$32.43
|
| Rate for Payer: Managed Health Services Medicaid |
$33.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$32.43
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$32.43
|
| Rate for Payer: United Healthcare Medicaid |
$32.43
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
|
Facility
|
IP
|
$28,090.40
|
|
|
Service Code
|
MSDRG 729
|
| Min. Negotiated Rate |
$8,614.51 |
| Max. Negotiated Rate |
$28,090.40 |
| Rate for Payer: Aetna Managed Medicare |
$8,614.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,099.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17,705.95
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,821.81
|
| Rate for Payer: Anthem Medicare Advantage |
$8,614.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,614.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,614.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,614.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,673.75
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,614.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,359.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,614.51
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,614.51
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,614.51
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,614.51
|
| Rate for Payer: NAPHCARE Commercial |
$12,921.76
|
| Rate for Payer: Quartz Medicare Advantage |
$8,614.51
|
| Rate for Payer: The Alliance Commercial |
$28,090.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,614.51
|
| Rate for Payer: United Healthcare PPO |
$15,849.82
|
| Rate for Payer: Wellcare Medicare |
$8,614.51
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$17,519.84
|
|
|
Service Code
|
MSDRG 730
|
| Min. Negotiated Rate |
$5,653.09 |
| Max. Negotiated Rate |
$17,519.84 |
| Rate for Payer: Aetna Managed Medicare |
$5,653.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14,662.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,238.69
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,677.49
|
| Rate for Payer: Anthem Medicare Advantage |
$5,653.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,653.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,653.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,653.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,852.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,653.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,606.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,653.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,653.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,653.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,653.09
|
| Rate for Payer: NAPHCARE Commercial |
$8,479.63
|
| Rate for Payer: Quartz Medicare Advantage |
$5,653.09
|
| Rate for Payer: The Alliance Commercial |
$17,519.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,653.09
|
| Rate for Payer: United Healthcare PPO |
$9,813.97
|
| Rate for Payer: Wellcare Medicare |
$5,653.09
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$50,480.56
|
|
|
Service Code
|
MSDRG 717
|
| Min. Negotiated Rate |
$14,984.59 |
| Max. Negotiated Rate |
$50,480.56 |
| Rate for Payer: Aetna Managed Medicare |
$14,984.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$41,249.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31,617.18
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30,038.38
|
| Rate for Payer: Anthem Medicare Advantage |
$14,984.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,984.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,984.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,984.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33,345.36
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,984.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36,781.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,984.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,984.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,984.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,984.59
|
| Rate for Payer: NAPHCARE Commercial |
$22,476.89
|
| Rate for Payer: Quartz Medicare Advantage |
$14,984.59
|
| Rate for Payer: The Alliance Commercial |
$50,480.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,984.59
|
| Rate for Payer: United Healthcare PPO |
$28,635.13
|
| Rate for Payer: Wellcare Medicare |
$14,984.59
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$32,843.20
|
|
|
Service Code
|
MSDRG 718
|
| Min. Negotiated Rate |
$10,792.51 |
| Max. Negotiated Rate |
$32,843.20 |
| Rate for Payer: Aetna Managed Medicare |
$10,792.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,305.37
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22,462.33
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21,340.68
|
| Rate for Payer: Anthem Medicare Advantage |
$10,792.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,792.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,792.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,792.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23,690.11
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,792.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23,845.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,792.51
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,792.51
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,792.51
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,792.51
|
| Rate for Payer: NAPHCARE Commercial |
$16,188.76
|
| Rate for Payer: Quartz Medicare Advantage |
$10,792.51
|
| Rate for Payer: The Alliance Commercial |
$32,843.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,792.51
|
| Rate for Payer: United Healthcare PPO |
$18,563.81
|
| Rate for Payer: Wellcare Medicare |
$10,792.51
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$61,369.36
|
|
|
Service Code
|
MSDRG 715
|
| Min. Negotiated Rate |
$17,640.46 |
| Max. Negotiated Rate |
$61,369.36 |
| Rate for Payer: Aetna Managed Medicare |
$17,640.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$48,816.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$37,417.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$35,548.73
|
| Rate for Payer: Anthem Medicare Advantage |
$17,640.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17,640.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17,640.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17,640.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$39,462.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17,640.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44,768.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17,640.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17,640.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17,640.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17,640.46
|
| Rate for Payer: NAPHCARE Commercial |
$26,460.69
|
| Rate for Payer: Quartz Medicare Advantage |
$17,640.46
|
| Rate for Payer: The Alliance Commercial |
$61,369.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,640.46
|
| Rate for Payer: United Healthcare PPO |
$34,852.54
|
| Rate for Payer: Wellcare Medicare |
$17,640.46
|
|
