|
VACUUM LINE CELL SAVER ELITE SMARTSUCTION FILTERED NON-STERILE HAR-A-1000
|
Facility
|
IP
|
$246.00
|
|
| Hospital Charge Code |
5804220
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.36 |
| Max. Negotiated Rate |
$235.37 |
| Rate for Payer: Aetna Commercial |
$230.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$220.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$135.60
|
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Cigna Commercial |
$235.37
|
| Rate for Payer: Health EOS Commercial |
$227.70
|
| Rate for Payer: HFN Commercial |
$235.37
|
| Rate for Payer: Multiplan Commercial |
$204.67
|
| Rate for Payer: Preferred Network Access Commercial |
$235.37
|
| Rate for Payer: Quartz Beloit One Network |
$125.36
|
| Rate for Payer: Quartz Commercial |
$153.50
|
| Rate for Payer: WEA Trust Commercial |
$140.71
|
| Rate for Payer: WPS Commercial |
$189.49
|
|
|
VAGAL NERVE STIMULATOR, INSERTION
|
Facility
|
IP
|
$4,048.00
|
|
| Hospital Charge Code |
2960486
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,062.86 |
| Max. Negotiated Rate |
$3,873.13 |
| Rate for Payer: Aetna Commercial |
$3,788.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,620.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,231.26
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cigna Commercial |
$3,873.13
|
| Rate for Payer: Health EOS Commercial |
$3,746.83
|
| Rate for Payer: HFN Commercial |
$3,873.13
|
| Rate for Payer: Multiplan Commercial |
$3,367.94
|
| Rate for Payer: Preferred Network Access Commercial |
$3,873.13
|
| Rate for Payer: Quartz Beloit One Network |
$2,062.86
|
| Rate for Payer: Quartz Commercial |
$2,525.95
|
| Rate for Payer: WEA Trust Commercial |
$2,315.46
|
| Rate for Payer: WPS Commercial |
$3,118.17
|
|
|
VAGAL NERVE STIMULATOR, INSERTION
|
Facility
|
OP
|
$4,048.00
|
|
| Hospital Charge Code |
2960486
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,178.78 |
| Max. Negotiated Rate |
$3,873.13 |
| Rate for Payer: Aetna Commercial |
$3,788.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,620.53
|
| Rate for Payer: Aetna Managed Medicare |
$1,178.78
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,736.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,104.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,020.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,231.26
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cigna Commercial |
$3,873.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,355.94
|
| Rate for Payer: Health EOS Commercial |
$3,746.83
|
| Rate for Payer: HFN Commercial |
$3,873.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,157.44
|
| Rate for Payer: Multiplan Commercial |
$3,367.94
|
| Rate for Payer: NAPHCARE Commercial |
$2,525.95
|
| Rate for Payer: Preferred Network Access Commercial |
$3,873.13
|
| Rate for Payer: Quartz Beloit One Network |
$2,062.86
|
| Rate for Payer: Quartz Commercial |
$2,736.45
|
| Rate for Payer: Quartz Medicare Advantage |
$2,525.95
|
| Rate for Payer: The Alliance Commercial |
$2,104.96
|
| Rate for Payer: WEA Trust Commercial |
$2,315.46
|
| Rate for Payer: WPS Commercial |
$3,118.17
|
|
|
VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$46,676.24
|
|
|
Service Code
|
MSDRG 746
|
| Min. Negotiated Rate |
$13,809.83 |
| Max. Negotiated Rate |
$46,676.24 |
| Rate for Payer: Aetna Managed Medicare |
$13,809.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$37,902.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29,051.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27,600.99
|
| Rate for Payer: Anthem Medicare Advantage |
$13,809.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,809.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,809.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,809.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30,639.63
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,809.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33,991.31
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,809.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,809.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,809.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,809.83
|
| Rate for Payer: NAPHCARE Commercial |
$20,714.74
|
| Rate for Payer: Quartz Medicare Advantage |
$13,809.83
|
| Rate for Payer: The Alliance Commercial |
$46,676.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,809.83
|
| Rate for Payer: United Healthcare PPO |
$26,462.66
|
| Rate for Payer: Wellcare Medicare |
$13,809.83
|
|
|
VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,863.28
|
|
|
Service Code
|
MSDRG 747
|
| Min. Negotiated Rate |
$7,090.52 |
| Max. Negotiated Rate |
$24,863.28 |
| Rate for Payer: Aetna Managed Medicare |
$7,090.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,317.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14,040.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13,338.92
|
| Rate for Payer: Anthem Medicare Advantage |
$7,090.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,090.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,090.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,090.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14,807.42
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,090.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17,992.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,090.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,090.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,090.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,090.52
|
| Rate for Payer: NAPHCARE Commercial |
$10,635.78
|
| Rate for Payer: Quartz Medicare Advantage |
$7,090.52
|
| Rate for Payer: The Alliance Commercial |
$24,863.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,090.52
|
| Rate for Payer: United Healthcare PPO |
$14,007.32
|
| Rate for Payer: Wellcare Medicare |
$7,090.52
|
|
|
VAGINAL CONDYLOMA, CAUTERY OF
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959949
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.95 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Aetna Managed Medicare |
$292.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$680.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$523.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$502.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$585.49
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$784.68
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: NAPHCARE Commercial |
$627.74
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$680.06
|
| Rate for Payer: Quartz Medicare Advantage |
$627.74
|
| Rate for Payer: The Alliance Commercial |
$523.12
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
VAGINAL CONDYLOMA, CAUTERY OF
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959949
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.66 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$627.74
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$2,981.23
|
|
|
Service Code
|
APR-DRG 5601
|
| Min. Negotiated Rate |
$2,648.11 |
| Max. Negotiated Rate |
$2,981.23 |
| Rate for Payer: Anthem Medicaid |
$2,854.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$2,854.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,854.69
|
| Rate for Payer: Dean Health Medicaid |
$2,854.69
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$2,648.11
|
| Rate for Payer: Managed Health Services Medicaid |
$2,981.23
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,854.69
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$2,854.69
|
| Rate for Payer: United Healthcare Medicaid |
$2,854.69
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$10,521.97
|
|
|
Service Code
|
APR-DRG 5604
|
| Min. Negotiated Rate |
$9,346.27 |
| Max. Negotiated Rate |
$10,521.97 |
| Rate for Payer: Anthem Medicaid |
$10,075.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,075.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,075.37
|
| Rate for Payer: Dean Health Medicaid |
$10,075.37
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,346.27
|
| Rate for Payer: Managed Health Services Medicaid |
$10,521.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,075.37
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,075.37
|
| Rate for Payer: United Healthcare Medicaid |
$10,075.37
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$5,260.99
|
|
|
Service Code
|
APR-DRG 5603
|
| 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
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$3,507.32
|
|
|
Service Code
|
APR-DRG 5602
|
| Min. Negotiated Rate |
$3,115.42 |
| Max. Negotiated Rate |
$3,507.32 |
| Rate for Payer: Anthem Medicaid |
$3,358.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$3,358.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,358.46
|
| Rate for Payer: Dean Health Medicaid |
$3,358.46
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3,115.42
|
| Rate for Payer: Managed Health Services Medicaid |
$3,507.32
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,358.46
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$3,358.46
|
| Rate for Payer: United Healthcare Medicaid |
$3,358.46
|
|
|
VAGINAL DELIVERY IN OPERATING ROOM
|
Facility
|
IP
|
$270.00
|
|
| Hospital Charge Code |
2960488
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$137.59 |
| Max. Negotiated Rate |
$258.34 |
| Rate for Payer: Aetna Commercial |
$252.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$241.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$148.82
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna Commercial |
$258.34
|
| Rate for Payer: Health EOS Commercial |
$249.91
|
| Rate for Payer: HFN Commercial |
$258.34
|
| Rate for Payer: Multiplan Commercial |
$224.64
|
| Rate for Payer: Preferred Network Access Commercial |
$258.34
|
| Rate for Payer: Quartz Beloit One Network |
$137.59
|
| Rate for Payer: Quartz Commercial |
$168.48
|
| Rate for Payer: WEA Trust Commercial |
$154.44
|
| Rate for Payer: WPS Commercial |
$207.98
|
|
|
VAGINAL DELIVERY IN OPERATING ROOM
|
Facility
|
OP
|
$270.00
|
|
| Hospital Charge Code |
2960488
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$78.62 |
| Max. Negotiated Rate |
$258.34 |
| Rate for Payer: Aetna Commercial |
$252.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$241.49
|
| Rate for Payer: Aetna Managed Medicare |
$78.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$182.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$140.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$134.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$148.82
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna Commercial |
$258.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$157.14
|
| Rate for Payer: Health EOS Commercial |
$249.91
|
| Rate for Payer: HFN Commercial |
$258.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$210.60
|
| Rate for Payer: Multiplan Commercial |
$224.64
|
| Rate for Payer: NAPHCARE Commercial |
$168.48
|
| Rate for Payer: Preferred Network Access Commercial |
$258.34
|
| Rate for Payer: Quartz Beloit One Network |
$137.59
|
| Rate for Payer: Quartz Commercial |
$182.52
|
| Rate for Payer: Quartz Medicare Advantage |
$168.48
|
| Rate for Payer: The Alliance Commercial |
$140.40
|
| Rate for Payer: WEA Trust Commercial |
$154.44
|
| Rate for Payer: WPS Commercial |
$207.98
|
|
|
VAGINAL DELIVERY PROCEDURES
|
Facility
|
OP
|
$516.95
|
|
|
Service Code
|
EAPG 00195
|
| Min. Negotiated Rate |
$497.06 |
| Max. Negotiated Rate |
$516.95 |
| Rate for Payer: Anthem Medicaid |
$497.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$497.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$497.06
|
| Rate for Payer: Dean Health Medicaid |
$497.06
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$497.06
|
| Rate for Payer: Managed Health Services Medicaid |
$516.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$497.06
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$497.06
|
| Rate for Payer: United Healthcare Medicaid |
$497.06
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$4,208.79
|
|
|
Service Code
|
APR-DRG 5422
|
| Min. Negotiated Rate |
$3,738.51 |
| Max. Negotiated Rate |
$4,208.79 |
| Rate for Payer: Anthem Medicaid |
$4,030.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,030.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,030.15
|
| Rate for Payer: Dean Health Medicaid |
$4,030.15
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3,738.51
|
| Rate for Payer: Managed Health Services Medicaid |
$4,208.79
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,030.15
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,030.15
|
| Rate for Payer: United Healthcare Medicaid |
$4,030.15
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$7,891.48
|
|
|
Service Code
|
APR-DRG 5423
|
| Min. Negotiated Rate |
$7,009.70 |
| Max. Negotiated Rate |
$7,891.48 |
| Rate for Payer: Anthem Medicaid |
$7,556.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,556.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,556.53
|
| Rate for Payer: Dean Health Medicaid |
$7,556.53
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,009.70
|
| Rate for Payer: Managed Health Services Medicaid |
$7,891.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,556.53
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,556.53
|
| Rate for Payer: United Healthcare Medicaid |
$7,556.53
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$21,657.73
|
|
|
Service Code
|
APR-DRG 5424
|
| Min. Negotiated Rate |
$19,237.74 |
| Max. Negotiated Rate |
$21,657.73 |
| Rate for Payer: Anthem Medicaid |
$20,738.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20,738.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20,738.47
|
| Rate for Payer: Dean Health Medicaid |
$20,738.47
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19,237.74
|
| Rate for Payer: Managed Health Services Medicaid |
$21,657.73
|
| Rate for Payer: Molina Healthcare Medicaid |
$20,738.47
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20,738.47
|
| Rate for Payer: United Healthcare Medicaid |
$20,738.47
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$3,419.64
|
|
|
Service Code
|
APR-DRG 5421
|
| Min. Negotiated Rate |
$3,037.54 |
| Max. Negotiated Rate |
$3,419.64 |
| Rate for Payer: Anthem Medicaid |
$3,274.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$3,274.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,274.49
|
| Rate for Payer: Dean Health Medicaid |
$3,274.49
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3,037.54
|
| Rate for Payer: Managed Health Services Medicaid |
$3,419.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,274.49
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$3,274.49
|
| Rate for Payer: United Healthcare Medicaid |
$3,274.49
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$34,013.20
|
|
|
Service Code
|
MSDRG 768
|
| Min. Negotiated Rate |
$7,800.00 |
| Max. Negotiated Rate |
$34,013.20 |
| Rate for Payer: Aetna Managed Medicare |
$8,713.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,696.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$8,713.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,713.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,713.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,713.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,901.29
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,713.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,800.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,713.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,713.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,713.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,713.31
|
| Rate for Payer: NAPHCARE Commercial |
$13,069.96
|
| Rate for Payer: Quartz Medicare Advantage |
$8,713.31
|
| Rate for Payer: The Alliance Commercial |
$34,013.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,713.31
|
| Rate for Payer: United Healthcare PPO |
$10,596.56
|
| Rate for Payer: Wellcare Medicare |
$8,713.31
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC
|
Facility
|
IP
|
$20,978.88
|
|
|
Service Code
|
MSDRG 806
|
| Min. Negotiated Rate |
$6,281.06 |
| Max. Negotiated Rate |
$20,978.88 |
| Rate for Payer: Aetna Managed Medicare |
$6,281.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,696.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$6,281.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,281.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,281.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,281.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13,299.34
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,281.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,143.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,281.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,281.06
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,281.06
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,281.06
|
| Rate for Payer: NAPHCARE Commercial |
$9,421.59
|
| Rate for Payer: Quartz Medicare Advantage |
$6,281.06
|
| Rate for Payer: The Alliance Commercial |
$20,978.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,281.06
|
| Rate for Payer: United Healthcare PPO |
$11,789.08
|
| Rate for Payer: Wellcare Medicare |
$6,281.06
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC
|
Facility
|
IP
|
$28,208.96
|
|
|
Service Code
|
MSDRG 805
|
| Min. Negotiated Rate |
$7,944.56 |
| Max. Negotiated Rate |
$28,208.96 |
| Rate for Payer: Aetna Managed Medicare |
$8,771.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,696.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$8,771.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,771.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,771.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,771.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19,035.34
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,771.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,446.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,771.51
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,771.51
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,771.51
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,771.51
|
| Rate for Payer: NAPHCARE Commercial |
$13,157.26
|
| Rate for Payer: Quartz Medicare Advantage |
$8,771.51
|
| Rate for Payer: The Alliance Commercial |
$28,208.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,771.51
|
| Rate for Payer: United Healthcare PPO |
$15,917.70
|
| Rate for Payer: Wellcare Medicare |
$8,771.51
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC
|
Facility
|
IP
|
$18,424.64
|
|
|
Service Code
|
MSDRG 807
|
| Min. Negotiated Rate |
$5,669.94 |
| Max. Negotiated Rate |
$18,424.64 |
| Rate for Payer: Aetna Managed Medicare |
$5,669.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,696.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$5,669.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,669.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,669.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,669.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,891.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,669.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13,269.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,669.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,669.94
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,669.94
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,669.94
|
| Rate for Payer: NAPHCARE Commercial |
$8,504.92
|
| Rate for Payer: Quartz Medicare Advantage |
$5,669.94
|
| Rate for Payer: The Alliance Commercial |
$18,424.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,669.94
|
| Rate for Payer: United Healthcare PPO |
$10,330.25
|
| Rate for Payer: Wellcare Medicare |
$5,669.94
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$5,611.72
|
|
|
Service Code
|
APR-DRG 5412
|
| 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
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$4,997.94
|
|
|
Service Code
|
APR-DRG 5411
|
| 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
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$8,242.21
|
|
|
Service Code
|
APR-DRG 5413
|
| Min. Negotiated Rate |
$7,321.25 |
| Max. Negotiated Rate |
$8,242.21 |
| Rate for Payer: Anthem Medicaid |
$7,892.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,892.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,892.37
|
| Rate for Payer: Dean Health Medicaid |
$7,892.37
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,321.25
|
| Rate for Payer: Managed Health Services Medicaid |
$8,242.21
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,892.37
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,892.37
|
| Rate for Payer: United Healthcare Medicaid |
$7,892.37
|
|
