|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$42,825.12
|
|
|
Service Code
|
MSDRG 306
|
| Min. Negotiated Rate |
$12,574.57 |
| Max. Negotiated Rate |
$42,825.12 |
| Rate for Payer: Aetna Managed Medicare |
$12,574.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$34,382.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,354.06
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25,038.08
|
| Rate for Payer: Anthem Medicare Advantage |
$12,574.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,574.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,574.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,574.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27,794.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,574.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31,166.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,574.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,574.57
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,574.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,574.57
|
| Rate for Payer: NAPHCARE Commercial |
$18,861.85
|
| Rate for Payer: Quartz Medicare Advantage |
$12,574.57
|
| Rate for Payer: The Alliance Commercial |
$42,825.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,574.57
|
| Rate for Payer: United Healthcare PPO |
$24,263.37
|
| Rate for Payer: Wellcare Medicare |
$12,574.57
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$26,395.20
|
|
|
Service Code
|
MSDRG 307
|
| Min. Negotiated Rate |
$7,500.23 |
| Max. Negotiated Rate |
$26,395.20 |
| Rate for Payer: Aetna Managed Medicare |
$7,500.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,925.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,272.58
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,509.94
|
| Rate for Payer: Anthem Medicare Advantage |
$7,500.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,500.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,500.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,500.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,107.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,500.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19,115.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,500.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,500.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,500.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,500.23
|
| Rate for Payer: NAPHCARE Commercial |
$11,250.35
|
| Rate for Payer: Quartz Medicare Advantage |
$7,500.23
|
| Rate for Payer: The Alliance Commercial |
$26,395.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,500.23
|
| Rate for Payer: United Healthcare PPO |
$14,881.99
|
| Rate for Payer: Wellcare Medicare |
$7,500.23
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
|
IP
|
$194,868.96
|
|
|
Service Code
|
MSDRG 275
|
| Min. Negotiated Rate |
$55,112.78 |
| Max. Negotiated Rate |
$194,868.96 |
| Rate for Payer: Aetna Managed Medicare |
$55,112.78
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$155,579.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$119,250.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$113,295.78
|
| Rate for Payer: Anthem Medicare Advantage |
$55,112.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$55,112.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$55,112.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$55,112.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$125,768.70
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$55,112.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$142,686.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$55,112.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$55,112.78
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$55,112.78
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$55,112.78
|
| Rate for Payer: NAPHCARE Commercial |
$82,669.17
|
| Rate for Payer: Quartz Medicare Advantage |
$55,112.78
|
| Rate for Payer: The Alliance Commercial |
$194,868.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$55,112.78
|
| Rate for Payer: United Healthcare PPO |
$111,082.90
|
| Rate for Payer: Wellcare Medicare |
$55,112.78
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR
|
Facility
|
IP
|
$172,042.00
|
|
|
Service Code
|
MSDRG 276
|
| Min. Negotiated Rate |
$46,506.50 |
| Max. Negotiated Rate |
$172,042.00 |
| Rate for Payer: Aetna Managed Medicare |
$46,506.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$131,059.21
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$100,455.82
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$95,439.59
|
| Rate for Payer: Anthem Medicare Advantage |
$46,506.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$46,506.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$46,506.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$46,506.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$105,946.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$46,506.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$125,942.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$46,506.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$46,506.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$46,506.50
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$46,506.50
|
| Rate for Payer: NAPHCARE Commercial |
$69,759.75
|
| Rate for Payer: Quartz Medicare Advantage |
$46,506.50
|
| Rate for Payer: The Alliance Commercial |
$172,042.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$46,506.50
|
| Rate for Payer: United Healthcare PPO |
$98,048.13
|
| Rate for Payer: Wellcare Medicare |
$46,506.50
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
|
IP
|
$132,563.60
|
|
|
Service Code
|
MSDRG 277
|
| Min. Negotiated Rate |
$35,876.17 |
| Max. Negotiated Rate |
$132,563.60 |
| Rate for Payer: Aetna Managed Medicare |
$35,876.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$100,771.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$77,240.90
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$73,383.90
|
| Rate for Payer: Anthem Medicare Advantage |
$35,876.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35,876.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35,876.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$35,876.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81,462.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$35,876.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$96,987.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35,876.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35,876.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$35,876.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$35,876.17
|
| Rate for Payer: NAPHCARE Commercial |
$53,814.26
|
| Rate for Payer: Quartz Medicare Advantage |
$35,876.17
|
| Rate for Payer: The Alliance Commercial |
$132,563.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35,876.17
|
| Rate for Payer: United Healthcare PPO |
$75,505.67
|
| Rate for Payer: Wellcare Medicare |
$35,876.17
|
|
|
CARDIAC DRUG STRESS TEST 93024
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
CPT 93024
|
| Hospital Charge Code |
3015356
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$107.49 |
| Max. Negotiated Rate |
$458.22 |
| Rate for Payer: Aetna Commercial |
$431.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$390.85
|
| Rate for Payer: Aetna Managed Medicare |
$114.56
|
| Rate for Payer: Anthem Medicare Advantage |
$114.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$114.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$114.56
|
| Rate for Payer: Cash Price |
$131.10
|
| Rate for Payer: Cash Price |
$131.10
|
| Rate for Payer: Cash Price |
$131.10
|
| Rate for Payer: Cigna Commercial |
$431.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$107.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$114.56
|
| Rate for Payer: Health EOS Commercial |
$413.58
|
| Rate for Payer: HFN Commercial |
$431.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$385.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$385.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$114.56
|
| Rate for Payer: Multiplan Commercial |
$363.58
|
| Rate for Payer: NAPHCARE Commercial |
$171.83
|
| Rate for Payer: Preferred Network Access Commercial |
$431.76
|
| Rate for Payer: Quartz Beloit One Network |
$199.97
|
| Rate for Payer: Quartz Commercial |
$259.05
|
| Rate for Payer: Quartz Medicare Advantage |
$114.56
|
| Rate for Payer: The Alliance Commercial |
$435.31
|
| Rate for Payer: United Healthcare Medicaid |
$107.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$114.56
|
| Rate for Payer: WEA Trust Commercial |
$249.96
|
| Rate for Payer: WPS Commercial |
$458.22
|
|
|
CARDIAC ELECTROPHYSIOLOGIC TESTS AND MONITORING
|
Facility
|
OP
|
$659.08
|
|
|
Service Code
|
EAPG 00082
|
| Min. Negotiated Rate |
$633.73 |
| Max. Negotiated Rate |
$659.08 |
| Rate for Payer: Anthem Medicaid |
$633.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$633.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$633.73
|
| Rate for Payer: Dean Health Medicaid |
$633.73
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$633.73
|
| Rate for Payer: Managed Health Services Medicaid |
$659.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$633.73
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$633.73
|
| Rate for Payer: United Healthcare Medicaid |
$633.73
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$11,661.85
|
|
|
Service Code
|
APR-DRG 1771
|
| 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
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$31,653.60
|
|
|
Service Code
|
APR-DRG 1774
|
| Min. Negotiated Rate |
$28,116.70 |
| Max. Negotiated Rate |
$31,653.60 |
| Rate for Payer: Anthem Medicaid |
$30,310.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$30,310.07
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$30,310.07
|
| Rate for Payer: Dean Health Medicaid |
$30,310.07
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$28,116.70
|
| Rate for Payer: Managed Health Services Medicaid |
$31,653.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$30,310.07
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$30,310.07
|
| Rate for Payer: United Healthcare Medicaid |
$30,310.07
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$22,096.14
|
|
|
Service Code
|
APR-DRG 1773
|
| Min. Negotiated Rate |
$19,627.17 |
| Max. Negotiated Rate |
$22,096.14 |
| Rate for Payer: Anthem Medicaid |
$21,158.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21,158.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,158.27
|
| Rate for Payer: Dean Health Medicaid |
$21,158.27
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19,627.17
|
| Rate for Payer: Managed Health Services Medicaid |
$22,096.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$21,158.27
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21,158.27
|
| Rate for Payer: United Healthcare Medicaid |
$21,158.27
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$17,711.99
|
|
|
Service Code
|
APR-DRG 1772
|
| 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
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$75,224.24
|
|
|
Service Code
|
MSDRG 258
|
| Min. Negotiated Rate |
$24,569.60 |
| Max. Negotiated Rate |
$75,224.24 |
| Rate for Payer: Aetna Managed Medicare |
$24,569.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$68,558.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$52,549.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$49,925.20
|
| Rate for Payer: Anthem Medicare Advantage |
$24,569.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24,569.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24,569.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$24,569.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$55,421.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$24,569.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$54,930.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24,569.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24,569.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$24,569.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$24,569.60
|
| Rate for Payer: NAPHCARE Commercial |
$36,854.41
|
| Rate for Payer: Quartz Medicare Advantage |
$24,569.60
|
| Rate for Payer: The Alliance Commercial |
$75,224.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,569.60
|
| Rate for Payer: United Healthcare PPO |
$42,764.03
|
| Rate for Payer: Wellcare Medicare |
$24,569.60
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
|
IP
|
$51,943.84
|
|
|
Service Code
|
MSDRG 259
|
| Min. Negotiated Rate |
$15,992.43 |
| Max. Negotiated Rate |
$51,943.84 |
| Rate for Payer: Aetna Managed Medicare |
$15,992.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$44,120.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$33,818.09
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$32,129.39
|
| Rate for Payer: Anthem Medicare Advantage |
$15,992.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,992.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,992.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,992.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35,666.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,992.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37,854.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,992.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,992.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,992.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,992.43
|
| Rate for Payer: NAPHCARE Commercial |
$23,988.65
|
| Rate for Payer: Quartz Medicare Advantage |
$15,992.43
|
| Rate for Payer: The Alliance Commercial |
$51,943.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,992.43
|
| Rate for Payer: United Healthcare PPO |
$29,470.32
|
| Rate for Payer: Wellcare Medicare |
$15,992.43
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
|
IP
|
$52,364.00
|
|
|
Service Code
|
MSDRG 261
|
| Min. Negotiated Rate |
$14,984.59 |
| Max. Negotiated Rate |
$52,364.00 |
| 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 |
$38,162.90
|
| 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 |
$52,364.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,984.59
|
| Rate for Payer: United Healthcare PPO |
$29,710.31
|
| Rate for Payer: Wellcare Medicare |
$14,984.59
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$91,996.32
|
|
|
Service Code
|
MSDRG 260
|
| Min. Negotiated Rate |
$25,417.36 |
| Max. Negotiated Rate |
$91,996.32 |
| Rate for Payer: Aetna Managed Medicare |
$25,417.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$70,973.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$54,400.61
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$51,684.13
|
| Rate for Payer: Anthem Medicare Advantage |
$25,417.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25,417.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25,417.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$25,417.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$57,374.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$25,417.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$67,232.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25,417.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25,417.36
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$25,417.36
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$25,417.36
|
| Rate for Payer: NAPHCARE Commercial |
$38,126.04
|
| Rate for Payer: Quartz Medicare Advantage |
$25,417.36
|
| Rate for Payer: The Alliance Commercial |
$91,996.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,417.36
|
| Rate for Payer: United Healthcare PPO |
$52,341.17
|
| Rate for Payer: Wellcare Medicare |
$25,417.36
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$45,824.48
|
|
|
Service Code
|
MSDRG 262
|
| Min. Negotiated Rate |
$12,988.88 |
| Max. Negotiated Rate |
$45,824.48 |
| Rate for Payer: Aetna Managed Medicare |
$12,988.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$35,563.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27,258.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25,897.68
|
| Rate for Payer: Anthem Medicare Advantage |
$12,988.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,988.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,988.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,988.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28,748.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,988.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33,366.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,988.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,988.88
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,988.88
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,988.88
|
| Rate for Payer: NAPHCARE Commercial |
$19,483.32
|
| Rate for Payer: Quartz Medicare Advantage |
$12,988.88
|
| Rate for Payer: The Alliance Commercial |
$45,824.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,988.88
|
| Rate for Payer: United Healthcare PPO |
$25,976.39
|
| Rate for Payer: Wellcare Medicare |
$12,988.88
|
|
|
CARDIAC REHABILITATION
|
Facility
|
OP
|
$27.52
|
|
|
Service Code
|
EAPG 00094
|
| Min. Negotiated Rate |
$26.46 |
| Max. Negotiated Rate |
$27.52 |
| Rate for Payer: Anthem Medicaid |
$26.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$26.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$26.46
|
| Rate for Payer: Dean Health Medicaid |
$26.46
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$26.46
|
| Rate for Payer: Managed Health Services Medicaid |
$27.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$26.46
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$26.46
|
| Rate for Payer: United Healthcare Medicaid |
$26.46
|
|
|
CARDIAC SHUNT IMAGING 7842826
|
Professional
|
Both
|
$488.00
|
|
|
Service Code
|
CPT 78428 26
|
| Hospital Charge Code |
3015314
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.37 |
| Max. Negotiated Rate |
$482.14 |
| Rate for Payer: Aetna Commercial |
$482.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$436.47
|
| Rate for Payer: Aetna Managed Medicare |
$35.37
|
| Rate for Payer: Anthem Medicare Advantage |
$35.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.37
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cigna Commercial |
$482.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$253.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.37
|
| Rate for Payer: Health EOS Commercial |
$461.84
|
| Rate for Payer: HFN Commercial |
$482.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$132.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$132.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.37
|
| Rate for Payer: Multiplan Commercial |
$406.02
|
| Rate for Payer: NAPHCARE Commercial |
$53.06
|
| Rate for Payer: Preferred Network Access Commercial |
$482.14
|
| Rate for Payer: Quartz Beloit One Network |
$223.31
|
| Rate for Payer: Quartz Commercial |
$289.29
|
| Rate for Payer: Quartz Medicare Advantage |
$35.37
|
| Rate for Payer: The Alliance Commercial |
$134.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.37
|
| Rate for Payer: WEA Trust Commercial |
$279.14
|
| Rate for Payer: WPS Commercial |
$176.85
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DIAGNOSES
|
Facility
|
OP
|
$112.69
|
|
|
Service Code
|
EAPG 00600
|
| Min. Negotiated Rate |
$108.35 |
| Max. Negotiated Rate |
$112.69 |
| Rate for Payer: Anthem Medicaid |
$108.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$108.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$108.35
|
| Rate for Payer: Dean Health Medicaid |
$108.35
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$108.35
|
| Rate for Payer: Managed Health Services Medicaid |
$112.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$108.35
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$108.35
|
| Rate for Payer: United Healthcare Medicaid |
$108.35
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$11,398.80
|
|
|
Service Code
|
APR-DRG 2003
|
| Min. Negotiated Rate |
$10,125.13 |
| Max. Negotiated Rate |
$11,398.80 |
| Rate for Payer: Anthem Medicaid |
$10,914.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,914.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,914.98
|
| Rate for Payer: Dean Health Medicaid |
$10,914.98
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,125.13
|
| Rate for Payer: Managed Health Services Medicaid |
$11,398.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,914.98
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,914.98
|
| Rate for Payer: United Healthcare Medicaid |
$10,914.98
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$7,716.11
|
|
|
Service Code
|
APR-DRG 2002
|
| Min. Negotiated Rate |
$6,853.93 |
| Max. Negotiated Rate |
$7,716.11 |
| Rate for Payer: Anthem Medicaid |
$7,388.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,388.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,388.60
|
| Rate for Payer: Dean Health Medicaid |
$7,388.60
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,853.93
|
| Rate for Payer: Managed Health Services Medicaid |
$7,716.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,388.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,388.60
|
| Rate for Payer: United Healthcare Medicaid |
$7,388.60
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$5,787.08
|
|
|
Service Code
|
APR-DRG 2001
|
| Min. Negotiated Rate |
$5,140.45 |
| Max. Negotiated Rate |
$5,787.08 |
| Rate for Payer: Anthem Medicaid |
$5,541.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$5,541.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,541.45
|
| Rate for Payer: Dean Health Medicaid |
$5,541.45
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,140.45
|
| Rate for Payer: Managed Health Services Medicaid |
$5,787.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,541.45
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5,541.45
|
| Rate for Payer: United Healthcare Medicaid |
$5,541.45
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$20,079.43
|
|
|
Service Code
|
APR-DRG 2004
|
| Min. Negotiated Rate |
$17,835.80 |
| Max. Negotiated Rate |
$20,079.43 |
| Rate for Payer: Anthem Medicaid |
$19,227.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$19,227.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19,227.16
|
| Rate for Payer: Dean Health Medicaid |
$19,227.16
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17,835.80
|
| Rate for Payer: Managed Health Services Medicaid |
$20,079.43
|
| Rate for Payer: Molina Healthcare Medicaid |
$19,227.16
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19,227.16
|
| Rate for Payer: United Healthcare Medicaid |
$19,227.16
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$176,329.92
|
|
|
Service Code
|
MSDRG 217
|
| Min. Negotiated Rate |
$50,861.72 |
| Max. Negotiated Rate |
$176,329.92 |
| Rate for Payer: Aetna Managed Medicare |
$50,861.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$143,467.79
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$109,966.90
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$104,475.73
|
| Rate for Payer: Anthem Medicare Advantage |
$50,861.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$50,861.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$50,861.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$50,861.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$115,977.64
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$50,861.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$129,088.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$50,861.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$50,861.72
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$50,861.72
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$50,861.72
|
| Rate for Payer: NAPHCARE Commercial |
$76,292.58
|
| Rate for Payer: Quartz Medicare Advantage |
$50,861.72
|
| Rate for Payer: The Alliance Commercial |
$176,329.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50,861.72
|
| Rate for Payer: United Healthcare PPO |
$100,496.88
|
| Rate for Payer: Wellcare Medicare |
$50,861.72
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$268,678.80
|
|
|
Service Code
|
MSDRG 216
|
| Min. Negotiated Rate |
$75,425.39 |
| Max. Negotiated Rate |
$268,678.80 |
| Rate for Payer: Aetna Managed Medicare |
$75,425.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$213,452.87
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$163,609.90
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$155,440.08
|
| Rate for Payer: Anthem Medicare Advantage |
$75,425.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$75,425.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$75,425.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$75,425.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$172,552.74
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$75,425.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$196,823.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$75,425.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$75,425.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$75,425.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$75,425.39
|
| Rate for Payer: NAPHCARE Commercial |
$113,138.08
|
| Rate for Payer: Quartz Medicare Advantage |
$75,425.39
|
| Rate for Payer: The Alliance Commercial |
$268,678.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$75,425.39
|
| Rate for Payer: United Healthcare PPO |
$153,229.61
|
| Rate for Payer: Wellcare Medicare |
$75,425.39
|
|
