|
Cardiac/Apnea Monitor - Nursery Daily Charges
|
Facility
|
OP
|
$851.00
|
|
| Hospital Charge Code |
3003953
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$247.81 |
| Max. Negotiated Rate |
$814.24 |
| Rate for Payer: Aetna Commercial |
$796.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$761.13
|
| Rate for Payer: Aetna Managed Medicare |
$247.81
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$575.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$442.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$424.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$469.07
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cigna Commercial |
$814.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$495.28
|
| Rate for Payer: Health EOS Commercial |
$787.69
|
| Rate for Payer: HFN Commercial |
$814.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$663.78
|
| Rate for Payer: Multiplan Commercial |
$708.03
|
| Rate for Payer: NAPHCARE Commercial |
$531.02
|
| Rate for Payer: Preferred Network Access Commercial |
$814.24
|
| Rate for Payer: Quartz Beloit One Network |
$433.67
|
| Rate for Payer: Quartz Commercial |
$575.28
|
| Rate for Payer: Quartz Medicare Advantage |
$531.02
|
| Rate for Payer: The Alliance Commercial |
$442.52
|
| Rate for Payer: United Healthcare PPO |
$663.78
|
| Rate for Payer: WEA Trust Commercial |
$486.77
|
| Rate for Payer: WPS Commercial |
$655.53
|
|
|
CARDIAC ARREST AND SHOCK
|
Facility
|
IP
|
$5,173.30
|
|
|
Service Code
|
APR-DRG 1962
|
| Min. Negotiated Rate |
$4,595.25 |
| Max. Negotiated Rate |
$5,173.30 |
| Rate for Payer: Anthem Medicaid |
$4,953.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,953.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,953.72
|
| Rate for Payer: Dean Health Medicaid |
$4,953.72
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,595.25
|
| Rate for Payer: Managed Health Services Medicaid |
$5,173.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,953.72
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,953.72
|
| Rate for Payer: United Healthcare Medicaid |
$4,953.72
|
|
|
CARDIAC ARREST AND SHOCK
|
Facility
|
IP
|
$4,208.79
|
|
|
Service Code
|
APR-DRG 1961
|
| 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
|
|
|
CARDIAC ARREST AND SHOCK
|
Facility
|
IP
|
$17,273.57
|
|
|
Service Code
|
APR-DRG 1964
|
| Min. Negotiated Rate |
$15,343.46 |
| Max. Negotiated Rate |
$17,273.57 |
| Rate for Payer: Anthem Medicaid |
$16,540.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$16,540.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16,540.40
|
| Rate for Payer: Dean Health Medicaid |
$16,540.40
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15,343.46
|
| Rate for Payer: Managed Health Services Medicaid |
$17,273.57
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,540.40
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16,540.40
|
| Rate for Payer: United Healthcare Medicaid |
$16,540.40
|
|
|
CARDIAC ARREST AND SHOCK
|
Facility
|
IP
|
$8,680.63
|
|
|
Service Code
|
APR-DRG 1963
|
| Min. Negotiated Rate |
$7,710.67 |
| Max. Negotiated Rate |
$8,680.63 |
| Rate for Payer: Anthem Medicaid |
$8,312.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$8,312.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8,312.18
|
| Rate for Payer: Dean Health Medicaid |
$8,312.18
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,710.67
|
| Rate for Payer: Managed Health Services Medicaid |
$8,680.63
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,312.18
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8,312.18
|
| Rate for Payer: United Healthcare Medicaid |
$8,312.18
|
|
|
CARDIAC ARREST OR OTHER CAUSES OF MORTALITY
|
Facility
|
OP
|
$213.58
|
|
|
Service Code
|
EAPG 00595
|
| Min. Negotiated Rate |
$205.36 |
| Max. Negotiated Rate |
$213.58 |
| Rate for Payer: Anthem Medicaid |
$205.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$205.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$205.36
|
| Rate for Payer: Dean Health Medicaid |
$205.36
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$205.36
|
| Rate for Payer: Managed Health Services Medicaid |
$213.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$205.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$205.36
|
| Rate for Payer: United Healthcare Medicaid |
$205.36
|
|
|
CARDIAC ARREST, UNEXPLAINED WITH CC
|
Facility
|
IP
|
$20,478.64
|
|
|
Service Code
|
MSDRG 297
|
| Min. Negotiated Rate |
$5,362.06 |
| Max. Negotiated Rate |
$20,478.64 |
| Rate for Payer: Aetna Managed Medicare |
$5,362.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$13,604.27
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10,427.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9,906.87
|
| Rate for Payer: Anthem Medicare Advantage |
$5,362.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,362.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,362.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,362.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10,997.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,362.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,776.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,362.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,362.06
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,362.06
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,362.06
|
| Rate for Payer: NAPHCARE Commercial |
$8,043.09
|
| Rate for Payer: Quartz Medicare Advantage |
$5,362.06
|
| Rate for Payer: The Alliance Commercial |
$20,478.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,362.06
|
| Rate for Payer: United Healthcare PPO |
$11,503.32
|
| Rate for Payer: Wellcare Medicare |
$5,362.06
|
|
|
CARDIAC ARREST, UNEXPLAINED WITH MCC
|
Facility
|
IP
|
$44,660.72
|
|
|
Service Code
|
MSDRG 296
|
| Min. Negotiated Rate |
$12,468.11 |
| Max. Negotiated Rate |
$44,660.72 |
| Rate for Payer: Aetna Managed Medicare |
$12,468.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$34,079.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,121.59
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,817.22
|
| Rate for Payer: Anthem Medicare Advantage |
$12,468.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,468.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,468.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,468.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27,549.39
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,468.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,512.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,468.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,468.11
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,468.11
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,468.11
|
| Rate for Payer: NAPHCARE Commercial |
$18,702.17
|
| Rate for Payer: Quartz Medicare Advantage |
$12,468.11
|
| Rate for Payer: The Alliance Commercial |
$44,660.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,468.11
|
| Rate for Payer: United Healthcare PPO |
$25,311.71
|
| Rate for Payer: Wellcare Medicare |
$12,468.11
|
|
|
CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC
|
Facility
|
IP
|
$12,490.40
|
|
|
Service Code
|
MSDRG 298
|
| Min. Negotiated Rate |
$3,992.02 |
| Max. Negotiated Rate |
$12,490.40 |
| Rate for Payer: Aetna Managed Medicare |
$3,992.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,929.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7,611.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,231.14
|
| Rate for Payer: Anthem Medicare Advantage |
$3,992.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,992.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,992.02
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,992.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,027.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,992.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,900.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,992.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,992.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,992.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,992.02
|
| Rate for Payer: NAPHCARE Commercial |
$5,988.03
|
| Rate for Payer: Quartz Medicare Advantage |
$3,992.02
|
| Rate for Payer: The Alliance Commercial |
$12,490.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,992.02
|
| Rate for Payer: United Healthcare PPO |
$6,929.46
|
| Rate for Payer: Wellcare Medicare |
$3,992.02
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DIAGNOSES
|
Facility
|
OP
|
$102.20
|
|
|
Service Code
|
EAPG 00601
|
| Min. Negotiated Rate |
$98.27 |
| Max. Negotiated Rate |
$102.20 |
| Rate for Payer: Anthem Medicaid |
$98.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$98.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$98.27
|
| Rate for Payer: Dean Health Medicaid |
$98.27
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$98.27
|
| Rate for Payer: Managed Health Services Medicaid |
$102.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$98.27
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$98.27
|
| Rate for Payer: United Healthcare Medicaid |
$98.27
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS
|
Facility
|
IP
|
$15,256.86
|
|
|
Service Code
|
APR-DRG 2014
|
| Min. Negotiated Rate |
$13,552.09 |
| Max. Negotiated Rate |
$15,256.86 |
| Rate for Payer: Anthem Medicaid |
$14,609.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$14,609.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14,609.28
|
| Rate for Payer: Dean Health Medicaid |
$14,609.28
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$13,552.09
|
| Rate for Payer: Managed Health Services Medicaid |
$15,256.86
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,609.28
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14,609.28
|
| Rate for Payer: United Healthcare Medicaid |
$14,609.28
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS
|
Facility
|
IP
|
$8,329.89
|
|
|
Service Code
|
APR-DRG 2013
|
| Min. Negotiated Rate |
$7,399.13 |
| Max. Negotiated Rate |
$8,329.89 |
| Rate for Payer: Anthem Medicaid |
$7,976.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,976.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,976.33
|
| Rate for Payer: Dean Health Medicaid |
$7,976.33
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,399.13
|
| Rate for Payer: Managed Health Services Medicaid |
$8,329.89
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,976.33
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,976.33
|
| Rate for Payer: United Healthcare Medicaid |
$7,976.33
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS
|
Facility
|
IP
|
$4,121.11
|
|
|
Service Code
|
APR-DRG 2011
|
| Min. Negotiated Rate |
$3,660.62 |
| Max. Negotiated Rate |
$4,121.11 |
| Rate for Payer: Anthem Medicaid |
$3,946.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$3,946.19
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,946.19
|
| Rate for Payer: Dean Health Medicaid |
$3,946.19
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3,660.62
|
| Rate for Payer: Managed Health Services Medicaid |
$4,121.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,946.19
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$3,946.19
|
| Rate for Payer: United Healthcare Medicaid |
$3,946.19
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS
|
Facility
|
IP
|
$5,611.72
|
|
|
Service Code
|
APR-DRG 2012
|
| 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
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC
|
Facility
|
IP
|
$20,923.76
|
|
|
Service Code
|
MSDRG 309
|
| Min. Negotiated Rate |
$6,140.92 |
| Max. Negotiated Rate |
$20,923.76 |
| Rate for Payer: Aetna Managed Medicare |
$6,140.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$16,052.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$12,304.02
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11,689.63
|
| Rate for Payer: Anthem Medicare Advantage |
$6,140.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,140.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,140.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,140.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,976.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,140.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,102.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,140.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,140.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,140.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,140.92
|
| Rate for Payer: NAPHCARE Commercial |
$9,211.38
|
| Rate for Payer: Quartz Medicare Advantage |
$6,140.92
|
| Rate for Payer: The Alliance Commercial |
$20,923.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,140.92
|
| Rate for Payer: United Healthcare PPO |
$11,757.50
|
| Rate for Payer: Wellcare Medicare |
$6,140.92
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC
|
Facility
|
IP
|
$33,573.28
|
|
|
Service Code
|
MSDRG 308
|
| Min. Negotiated Rate |
$9,727.26 |
| Max. Negotiated Rate |
$33,573.28 |
| Rate for Payer: Aetna Managed Medicare |
$9,727.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$26,270.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,135.98
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,130.50
|
| Rate for Payer: Anthem Medicare Advantage |
$9,727.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,727.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,727.26
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,727.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21,236.61
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,727.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24,380.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,727.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,727.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,727.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,727.26
|
| Rate for Payer: NAPHCARE Commercial |
$14,590.88
|
| Rate for Payer: Quartz Medicare Advantage |
$9,727.26
|
| Rate for Payer: The Alliance Commercial |
$33,573.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,727.26
|
| Rate for Payer: United Healthcare PPO |
$18,980.62
|
| Rate for Payer: Wellcare Medicare |
$9,727.26
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$15,622.88
|
|
|
Service Code
|
MSDRG 310
|
| Min. Negotiated Rate |
$4,842.09 |
| Max. Negotiated Rate |
$15,622.88 |
| Rate for Payer: Aetna Managed Medicare |
$4,842.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12,351.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9,467.59
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8,994.83
|
| Rate for Payer: Anthem Medicare Advantage |
$4,842.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4,842.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4,842.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4,842.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,985.09
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4,842.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,214.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4,842.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4,842.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4,842.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4,842.09
|
| Rate for Payer: NAPHCARE Commercial |
$7,263.14
|
| Rate for Payer: Quartz Medicare Advantage |
$4,842.09
|
| Rate for Payer: The Alliance Commercial |
$15,622.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,842.09
|
| Rate for Payer: United Healthcare PPO |
$8,730.89
|
| Rate for Payer: Wellcare Medicare |
$4,842.09
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
|
IP
|
$8,855.99
|
|
|
Service Code
|
APR-DRG 1911
|
| Min. Negotiated Rate |
$7,866.45 |
| Max. Negotiated Rate |
$8,855.99 |
| Rate for Payer: Anthem Medicaid |
$8,480.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$8,480.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8,480.10
|
| Rate for Payer: Dean Health Medicaid |
$8,480.10
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,866.45
|
| Rate for Payer: Managed Health Services Medicaid |
$8,855.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,480.10
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8,480.10
|
| Rate for Payer: United Healthcare Medicaid |
$8,480.10
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
|
IP
|
$14,292.35
|
|
|
Service Code
|
APR-DRG 1913
|
| Min. Negotiated Rate |
$12,695.35 |
| Max. Negotiated Rate |
$14,292.35 |
| Rate for Payer: Anthem Medicaid |
$13,685.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$13,685.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13,685.71
|
| Rate for Payer: Dean Health Medicaid |
$13,685.71
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12,695.35
|
| Rate for Payer: Managed Health Services Medicaid |
$14,292.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,685.71
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13,685.71
|
| Rate for Payer: United Healthcare Medicaid |
$13,685.71
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
|
IP
|
$21,306.99
|
|
|
Service Code
|
APR-DRG 1914
|
| Min. Negotiated Rate |
$18,926.20 |
| Max. Negotiated Rate |
$21,306.99 |
| Rate for Payer: Anthem Medicaid |
$20,402.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20,402.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20,402.62
|
| Rate for Payer: Dean Health Medicaid |
$20,402.62
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,926.20
|
| Rate for Payer: Managed Health Services Medicaid |
$21,306.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$20,402.62
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20,402.62
|
| Rate for Payer: United Healthcare Medicaid |
$20,402.62
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
|
IP
|
$10,521.97
|
|
|
Service Code
|
APR-DRG 1912
|
| 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
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
|
IP
|
$17,273.57
|
|
|
Service Code
|
APR-DRG 1923
|
| Min. Negotiated Rate |
$15,343.46 |
| Max. Negotiated Rate |
$17,273.57 |
| Rate for Payer: Anthem Medicaid |
$16,540.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$16,540.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16,540.40
|
| Rate for Payer: Dean Health Medicaid |
$16,540.40
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15,343.46
|
| Rate for Payer: Managed Health Services Medicaid |
$17,273.57
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,540.40
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16,540.40
|
| Rate for Payer: United Healthcare Medicaid |
$16,540.40
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
|
IP
|
$9,206.73
|
|
|
Service Code
|
APR-DRG 1921
|
| Min. Negotiated Rate |
$8,177.99 |
| Max. Negotiated Rate |
$9,206.73 |
| Rate for Payer: Anthem Medicaid |
$8,815.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$8,815.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8,815.95
|
| Rate for Payer: Dean Health Medicaid |
$8,815.95
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8,177.99
|
| Rate for Payer: Managed Health Services Medicaid |
$9,206.73
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,815.95
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8,815.95
|
| Rate for Payer: United Healthcare Medicaid |
$8,815.95
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
|
IP
|
$28,146.28
|
|
|
Service Code
|
APR-DRG 1924
|
| Min. Negotiated Rate |
$25,001.28 |
| Max. Negotiated Rate |
$28,146.28 |
| Rate for Payer: Anthem Medicaid |
$26,951.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$26,951.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$26,951.61
|
| Rate for Payer: Dean Health Medicaid |
$26,951.61
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$25,001.28
|
| Rate for Payer: Managed Health Services Medicaid |
$28,146.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$26,951.61
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$26,951.61
|
| Rate for Payer: United Healthcare Medicaid |
$26,951.61
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
|
IP
|
$11,837.22
|
|
|
Service Code
|
APR-DRG 1922
|
| Min. Negotiated Rate |
$10,514.56 |
| Max. Negotiated Rate |
$11,837.22 |
| Rate for Payer: Anthem Medicaid |
$11,334.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$11,334.79
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11,334.79
|
| Rate for Payer: Dean Health Medicaid |
$11,334.79
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,514.56
|
| Rate for Payer: Managed Health Services Medicaid |
$11,837.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,334.79
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11,334.79
|
| Rate for Payer: United Healthcare Medicaid |
$11,334.79
|
|
