|
OTHER RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$25,778.83
|
|
|
Service Code
|
APR-DRG 1213
|
| Min. Negotiated Rate |
$22,898.37 |
| Max. Negotiated Rate |
$25,778.83 |
| Rate for Payer: Anthem Medicaid |
$24,684.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$24,684.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$24,684.65
|
| Rate for Payer: Dean Health Medicaid |
$24,684.65
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$22,898.37
|
| Rate for Payer: Managed Health Services Medicaid |
$25,778.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,684.65
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$24,684.65
|
| Rate for Payer: United Healthcare Medicaid |
$24,684.65
|
|
|
OTHER RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$16,659.79
|
|
|
Service Code
|
APR-DRG 1212
|
| Min. Negotiated Rate |
$14,798.26 |
| Max. Negotiated Rate |
$16,659.79 |
| Rate for Payer: Anthem Medicaid |
$15,952.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$15,952.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15,952.67
|
| Rate for Payer: Dean Health Medicaid |
$15,952.67
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14,798.26
|
| Rate for Payer: Managed Health Services Medicaid |
$16,659.79
|
| Rate for Payer: Molina Healthcare Medicaid |
$15,952.67
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$15,952.67
|
| Rate for Payer: United Healthcare Medicaid |
$15,952.67
|
|
|
OTHER RESPIRATORY AND CHEST PROCEDURES
|
Facility
|
IP
|
$40,684.96
|
|
|
Service Code
|
APR-DRG 1214
|
| Min. Negotiated Rate |
$36,138.92 |
| Max. Negotiated Rate |
$40,684.96 |
| Rate for Payer: Anthem Medicaid |
$38,958.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$38,958.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$38,958.09
|
| Rate for Payer: Dean Health Medicaid |
$38,958.09
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$36,138.92
|
| Rate for Payer: Managed Health Services Medicaid |
$40,684.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$38,958.09
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$38,958.09
|
| Rate for Payer: United Healthcare Medicaid |
$38,958.09
|
|
|
OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES
|
Facility
|
IP
|
$4,997.94
|
|
|
Service Code
|
APR-DRG 1431
|
| Min. Negotiated Rate |
$4,439.48 |
| Max. Negotiated Rate |
$4,997.94 |
| Rate for Payer: Anthem Medicaid |
$4,785.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,785.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,785.80
|
| Rate for Payer: Dean Health Medicaid |
$4,785.80
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,439.48
|
| Rate for Payer: Managed Health Services Medicaid |
$4,997.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,785.80
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,785.80
|
| Rate for Payer: United Healthcare Medicaid |
$4,785.80
|
|
|
OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES
|
Facility
|
IP
|
$7,102.33
|
|
|
Service Code
|
APR-DRG 1432
|
| Min. Negotiated Rate |
$6,308.73 |
| Max. Negotiated Rate |
$7,102.33 |
| Rate for Payer: Anthem Medicaid |
$6,800.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,800.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,800.87
|
| Rate for Payer: Dean Health Medicaid |
$6,800.87
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,308.73
|
| Rate for Payer: Managed Health Services Medicaid |
$7,102.33
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,800.87
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,800.87
|
| Rate for Payer: United Healthcare Medicaid |
$6,800.87
|
|
|
OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES
|
Facility
|
IP
|
$18,150.40
|
|
|
Service Code
|
APR-DRG 1434
|
| Min. Negotiated Rate |
$16,122.32 |
| Max. Negotiated Rate |
$18,150.40 |
| Rate for Payer: Anthem Medicaid |
$17,380.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,380.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,380.01
|
| Rate for Payer: Dean Health Medicaid |
$17,380.01
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,122.32
|
| Rate for Payer: Managed Health Services Medicaid |
$18,150.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,380.01
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,380.01
|
| Rate for Payer: United Healthcare Medicaid |
$17,380.01
|
|
|
OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES
|
Facility
|
IP
|
$10,960.39
|
|
|
Service Code
|
APR-DRG 1433
|
| Min. Negotiated Rate |
$9,735.70 |
| Max. Negotiated Rate |
$10,960.39 |
| Rate for Payer: Anthem Medicaid |
$10,495.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,495.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,495.17
|
| Rate for Payer: Dean Health Medicaid |
$10,495.17
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,735.70
|
| Rate for Payer: Managed Health Services Medicaid |
$10,960.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,495.17
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,495.17
|
| Rate for Payer: United Healthcare Medicaid |
$10,495.17
|
|
|
OTHER RESPIRATORY SYSTEM DIAGNOSES
|
Facility
|
OP
|
$42.11
|
|
|
Service Code
|
EAPG 00576
|
| Min. Negotiated Rate |
$40.49 |
| Max. Negotiated Rate |
$42.11 |
| Rate for Payer: Anthem Medicaid |
$40.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$40.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$40.49
|
| Rate for Payer: Dean Health Medicaid |
$40.49
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$40.49
|
| Rate for Payer: Managed Health Services Medicaid |
$42.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$40.49
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$40.49
|
| Rate for Payer: United Healthcare Medicaid |
$40.49
|
|
|
OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$50,386.96
|
|
|
Service Code
|
MSDRG 205
|
| Min. Negotiated Rate |
$14,528.94 |
| Max. Negotiated Rate |
$50,386.96 |
| Rate for Payer: Aetna Managed Medicare |
$14,528.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$39,950.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30,622.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29,092.98
|
| Rate for Payer: Anthem Medicare Advantage |
$14,528.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,528.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,528.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,528.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32,295.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,528.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36,712.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,528.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,528.94
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,528.94
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,528.94
|
| Rate for Payer: NAPHCARE Commercial |
$21,793.40
|
| Rate for Payer: Quartz Medicare Advantage |
$14,528.94
|
| Rate for Payer: The Alliance Commercial |
$50,386.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,528.94
|
| Rate for Payer: United Healthcare PPO |
$28,581.45
|
| Rate for Payer: Wellcare Medicare |
$14,528.94
|
|
|
OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC
|
Facility
|
IP
|
$25,591.28
|
|
|
Service Code
|
MSDRG 206
|
| Min. Negotiated Rate |
$7,713.90 |
| Max. Negotiated Rate |
$25,591.28 |
| Rate for Payer: Aetna Managed Medicare |
$7,713.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,534.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,739.18
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,953.25
|
| Rate for Payer: Anthem Medicare Advantage |
$7,713.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,713.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,713.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,713.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,599.48
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,713.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18,525.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,713.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,713.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,713.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,713.90
|
| Rate for Payer: NAPHCARE Commercial |
$11,570.85
|
| Rate for Payer: Quartz Medicare Advantage |
$7,713.90
|
| Rate for Payer: The Alliance Commercial |
$25,591.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,713.90
|
| Rate for Payer: United Healthcare PPO |
$14,422.55
|
| Rate for Payer: Wellcare Medicare |
$7,713.90
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$50,650.08
|
|
|
Service Code
|
MSDRG 167
|
| Min. Negotiated Rate |
$14,317.57 |
| Max. Negotiated Rate |
$50,650.08 |
| Rate for Payer: Aetna Managed Medicare |
$14,317.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$39,348.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30,160.49
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28,654.44
|
| Rate for Payer: Anthem Medicare Advantage |
$14,317.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,317.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,317.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,317.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31,809.05
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,317.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36,905.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,317.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,317.57
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,317.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,317.57
|
| Rate for Payer: NAPHCARE Commercial |
$21,476.35
|
| Rate for Payer: Quartz Medicare Advantage |
$14,317.57
|
| Rate for Payer: The Alliance Commercial |
$50,650.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,317.57
|
| Rate for Payer: United Healthcare PPO |
$28,731.44
|
| Rate for Payer: Wellcare Medicare |
$14,317.57
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$112,529.04
|
|
|
Service Code
|
MSDRG 166
|
| Min. Negotiated Rate |
$29,130.83 |
| Max. Negotiated Rate |
$112,529.04 |
| Rate for Payer: Aetna Managed Medicare |
$29,130.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$81,553.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$62,510.19
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$59,388.76
|
| Rate for Payer: Anthem Medicare Advantage |
$29,130.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$29,130.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$29,130.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$29,130.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$65,926.97
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$29,130.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$82,292.18
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29,130.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$29,130.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$29,130.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$29,130.83
|
| Rate for Payer: NAPHCARE Commercial |
$43,696.24
|
| Rate for Payer: Quartz Medicare Advantage |
$29,130.83
|
| Rate for Payer: The Alliance Commercial |
$112,529.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,130.83
|
| Rate for Payer: United Healthcare PPO |
$64,065.52
|
| Rate for Payer: Wellcare Medicare |
$29,130.83
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$37,817.52
|
|
|
Service Code
|
MSDRG 168
|
| Min. Negotiated Rate |
$10,970.94 |
| Max. Negotiated Rate |
$37,817.52 |
| Rate for Payer: Aetna Managed Medicare |
$10,970.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,813.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22,852.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21,710.89
|
| Rate for Payer: Anthem Medicare Advantage |
$10,970.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,970.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,970.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,970.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24,101.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,970.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$27,493.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,970.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,970.94
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,970.94
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,970.94
|
| Rate for Payer: NAPHCARE Commercial |
$16,456.41
|
| Rate for Payer: Quartz Medicare Advantage |
$10,970.94
|
| Rate for Payer: The Alliance Commercial |
$37,817.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,970.94
|
| Rate for Payer: United Healthcare PPO |
$21,404.12
|
| Rate for Payer: Wellcare Medicare |
$10,970.94
|
|
|
OTHER SIGNIFICANT HIP AND FEMUR SURGERY
|
Facility
|
IP
|
$34,634.82
|
|
|
Service Code
|
APR-DRG 3094
|
| Min. Negotiated Rate |
$30,764.81 |
| Max. Negotiated Rate |
$34,634.82 |
| Rate for Payer: Anthem Medicaid |
$33,164.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$33,164.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$33,164.75
|
| Rate for Payer: Dean Health Medicaid |
$33,164.75
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$30,764.81
|
| Rate for Payer: Managed Health Services Medicaid |
$34,634.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$33,164.75
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$33,164.75
|
| Rate for Payer: United Healthcare Medicaid |
$33,164.75
|
|
|
OTHER SIGNIFICANT HIP AND FEMUR SURGERY
|
Facility
|
IP
|
$13,503.20
|
|
|
Service Code
|
APR-DRG 3091
|
| Min. Negotiated Rate |
$11,994.38 |
| Max. Negotiated Rate |
$13,503.20 |
| Rate for Payer: Anthem Medicaid |
$12,930.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,930.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,930.06
|
| Rate for Payer: Dean Health Medicaid |
$12,930.06
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,994.38
|
| Rate for Payer: Managed Health Services Medicaid |
$13,503.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,930.06
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,930.06
|
| Rate for Payer: United Healthcare Medicaid |
$12,930.06
|
|
|
OTHER SIGNIFICANT HIP AND FEMUR SURGERY
|
Facility
|
IP
|
$17,711.99
|
|
|
Service Code
|
APR-DRG 3092
|
| Min. Negotiated Rate |
$15,732.89 |
| Max. Negotiated Rate |
$17,711.99 |
| Rate for Payer: Anthem Medicaid |
$16,960.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$16,960.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16,960.20
|
| Rate for Payer: Dean Health Medicaid |
$16,960.20
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15,732.89
|
| Rate for Payer: Managed Health Services Medicaid |
$17,711.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,960.20
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16,960.20
|
| Rate for Payer: United Healthcare Medicaid |
$16,960.20
|
|
|
OTHER SIGNIFICANT HIP AND FEMUR SURGERY
|
Facility
|
IP
|
$24,112.85
|
|
|
Service Code
|
APR-DRG 3093
|
| Min. Negotiated Rate |
$21,418.54 |
| Max. Negotiated Rate |
$24,112.85 |
| Rate for Payer: Anthem Medicaid |
$23,089.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$23,089.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$23,089.38
|
| Rate for Payer: Dean Health Medicaid |
$23,089.38
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$21,418.54
|
| Rate for Payer: Managed Health Services Medicaid |
$24,112.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$23,089.38
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$23,089.38
|
| Rate for Payer: United Healthcare Medicaid |
$23,089.38
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DIAGNOSES
|
Facility
|
OP
|
$23.65
|
|
|
Service Code
|
EAPG 00675
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$23.65 |
| Rate for Payer: Anthem Medicaid |
$22.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$22.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$22.74
|
| Rate for Payer: Dean Health Medicaid |
$22.74
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$22.74
|
| Rate for Payer: Managed Health Services Medicaid |
$23.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$22.74
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$22.74
|
| Rate for Payer: United Healthcare Medicaid |
$22.74
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS
|
Facility
|
IP
|
$9,995.87
|
|
|
Service Code
|
APR-DRG 3853
|
| Min. Negotiated Rate |
$8,878.96 |
| Max. Negotiated Rate |
$9,995.87 |
| Rate for Payer: Anthem Medicaid |
$9,571.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$9,571.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9,571.60
|
| Rate for Payer: Dean Health Medicaid |
$9,571.60
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8,878.96
|
| Rate for Payer: Managed Health Services Medicaid |
$9,995.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,571.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$9,571.60
|
| Rate for Payer: United Healthcare Medicaid |
$9,571.60
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS
|
Facility
|
IP
|
$16,659.79
|
|
|
Service Code
|
APR-DRG 3854
|
| Min. Negotiated Rate |
$14,798.26 |
| Max. Negotiated Rate |
$16,659.79 |
| Rate for Payer: Anthem Medicaid |
$15,952.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$15,952.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15,952.67
|
| Rate for Payer: Dean Health Medicaid |
$15,952.67
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14,798.26
|
| Rate for Payer: Managed Health Services Medicaid |
$16,659.79
|
| Rate for Payer: Molina Healthcare Medicaid |
$15,952.67
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$15,952.67
|
| Rate for Payer: United Healthcare Medicaid |
$15,952.67
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS
|
Facility
|
IP
|
$4,734.89
|
|
|
Service Code
|
APR-DRG 3851
|
| Min. Negotiated Rate |
$4,205.82 |
| Max. Negotiated Rate |
$4,734.89 |
| Rate for Payer: Anthem Medicaid |
$4,533.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,533.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,533.92
|
| Rate for Payer: Dean Health Medicaid |
$4,533.92
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,205.82
|
| Rate for Payer: Managed Health Services Medicaid |
$4,734.89
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,533.92
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,533.92
|
| Rate for Payer: United Healthcare Medicaid |
$4,533.92
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS
|
Facility
|
IP
|
$6,137.82
|
|
|
Service Code
|
APR-DRG 3852
|
| 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 SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
|
Facility
|
IP
|
$48,625.20
|
|
|
Service Code
|
MSDRG 580
|
| Min. Negotiated Rate |
$13,740.14 |
| Max. Negotiated Rate |
$48,625.20 |
| Rate for Payer: Anthem Medicare Advantage |
$13,740.14
|
| Rate for Payer: Aetna Managed Medicare |
$13,740.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$37,703.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28,899.49
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27,456.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,740.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,740.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,740.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30,479.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,740.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35,421.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,740.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,740.14
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,740.14
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,740.14
|
| Rate for Payer: NAPHCARE Commercial |
$20,610.21
|
| Rate for Payer: Quartz Medicare Advantage |
$13,740.14
|
| Rate for Payer: The Alliance Commercial |
$48,625.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,740.14
|
| Rate for Payer: United Healthcare PPO |
$27,575.74
|
| Rate for Payer: Wellcare Medicare |
$13,740.14
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC
|
Facility
|
IP
|
$92,743.04
|
|
|
Service Code
|
MSDRG 579
|
| Min. Negotiated Rate |
$25,307.86 |
| Max. Negotiated Rate |
$92,743.04 |
| Rate for Payer: Aetna Managed Medicare |
$25,307.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$70,661.48
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$54,161.45
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$51,456.92
|
| Rate for Payer: Anthem Medicare Advantage |
$25,307.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25,307.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25,307.86
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$25,307.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$57,121.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$25,307.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$67,779.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25,307.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25,307.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$25,307.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$25,307.86
|
| Rate for Payer: NAPHCARE Commercial |
$37,961.79
|
| Rate for Payer: Quartz Medicare Advantage |
$25,307.86
|
| Rate for Payer: The Alliance Commercial |
$92,743.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,307.86
|
| Rate for Payer: United Healthcare PPO |
$52,767.46
|
| Rate for Payer: Wellcare Medicare |
$25,307.86
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$37,568.96
|
|
|
Service Code
|
MSDRG 581
|
| Min. Negotiated Rate |
$11,558.33 |
| Max. Negotiated Rate |
$37,568.96 |
| Rate for Payer: Aetna Managed Medicare |
$11,558.33
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31,487.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24,134.75
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22,929.59
|
| Rate for Payer: Anthem Medicare Advantage |
$11,558.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11,558.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11,558.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11,558.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25,453.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11,558.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$27,311.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11,558.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11,558.33
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11,558.33
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11,558.33
|
| Rate for Payer: NAPHCARE Commercial |
$17,337.50
|
| Rate for Payer: Quartz Medicare Advantage |
$11,558.33
|
| Rate for Payer: The Alliance Commercial |
$37,568.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,558.33
|
| Rate for Payer: United Healthcare PPO |
$21,262.02
|
| Rate for Payer: Wellcare Medicare |
$11,558.33
|
|
