|
ACUTE KIDNEY INJURY
|
Facility
|
IP
|
$20,342.48
|
|
|
Service Code
|
APR-DRG 4694
|
| Min. Negotiated Rate |
$18,069.46 |
| Max. Negotiated Rate |
$20,342.48 |
| Rate for Payer: Anthem Medicaid |
$19,479.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$19,479.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19,479.04
|
| Rate for Payer: Dean Health Medicaid |
$19,479.04
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,069.46
|
| Rate for Payer: Managed Health Services Medicaid |
$20,342.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$19,479.04
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19,479.04
|
| Rate for Payer: United Healthcare Medicaid |
$19,479.04
|
|
|
ACUTE KIDNEY INJURY
|
Facility
|
IP
|
$10,609.66
|
|
|
Service Code
|
APR-DRG 4693
|
| Min. Negotiated Rate |
$9,424.16 |
| Max. Negotiated Rate |
$10,609.66 |
| Rate for Payer: Anthem Medicaid |
$10,159.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,159.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,159.33
|
| Rate for Payer: Dean Health Medicaid |
$10,159.33
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,424.16
|
| Rate for Payer: Managed Health Services Medicaid |
$10,609.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,159.33
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,159.33
|
| Rate for Payer: United Healthcare Medicaid |
$10,159.33
|
|
|
ACUTE KIDNEY INJURY
|
Facility
|
IP
|
$4,384.15
|
|
|
Service Code
|
APR-DRG 4691
|
| Min. Negotiated Rate |
$3,894.28 |
| Max. Negotiated Rate |
$4,384.15 |
| Rate for Payer: Anthem Medicaid |
$4,198.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,198.07
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,198.07
|
| Rate for Payer: Dean Health Medicaid |
$4,198.07
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3,894.28
|
| Rate for Payer: Managed Health Services Medicaid |
$4,384.15
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,198.07
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,198.07
|
| Rate for Payer: United Healthcare Medicaid |
$4,198.07
|
|
|
ACUTE KIDNEY INJURY
|
Facility
|
IP
|
$6,137.82
|
|
|
Service Code
|
APR-DRG 4692
|
| 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
|
|
|
ACUTE LEUKEMIA
|
Facility
|
IP
|
$51,820.71
|
|
|
Service Code
|
APR-DRG 6904
|
| Min. Negotiated Rate |
$46,030.39 |
| Max. Negotiated Rate |
$51,820.71 |
| Rate for Payer: Anthem Medicaid |
$49,621.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$49,621.19
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$49,621.19
|
| Rate for Payer: Dean Health Medicaid |
$49,621.19
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$46,030.39
|
| Rate for Payer: Managed Health Services Medicaid |
$51,820.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$49,621.19
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$49,621.19
|
| Rate for Payer: United Healthcare Medicaid |
$49,621.19
|
|
|
ACUTE LEUKEMIA
|
Facility
|
IP
|
$22,534.56
|
|
|
Service Code
|
APR-DRG 6902
|
| Min. Negotiated Rate |
$20,016.60 |
| Max. Negotiated Rate |
$22,534.56 |
| Rate for Payer: Anthem Medicaid |
$21,578.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21,578.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,578.08
|
| Rate for Payer: Dean Health Medicaid |
$21,578.08
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$20,016.60
|
| Rate for Payer: Managed Health Services Medicaid |
$22,534.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$21,578.08
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21,578.08
|
| Rate for Payer: United Healthcare Medicaid |
$21,578.08
|
|
|
ACUTE LEUKEMIA
|
Facility
|
IP
|
$12,538.68
|
|
|
Service Code
|
APR-DRG 6901
|
| Min. Negotiated Rate |
$11,137.64 |
| Max. Negotiated Rate |
$12,538.68 |
| Rate for Payer: Anthem Medicaid |
$12,006.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,006.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,006.48
|
| Rate for Payer: Dean Health Medicaid |
$12,006.48
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,137.64
|
| Rate for Payer: Managed Health Services Medicaid |
$12,538.68
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,006.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,006.48
|
| Rate for Payer: United Healthcare Medicaid |
$12,006.48
|
|
|
ACUTE LEUKEMIA
|
Facility
|
IP
|
$34,985.56
|
|
|
Service Code
|
APR-DRG 6903
|
| Min. Negotiated Rate |
$31,076.35 |
| Max. Negotiated Rate |
$34,985.56 |
| Rate for Payer: Anthem Medicaid |
$33,500.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$33,500.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$33,500.60
|
| Rate for Payer: Dean Health Medicaid |
$33,500.60
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$31,076.35
|
| Rate for Payer: Managed Health Services Medicaid |
$34,985.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$33,500.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$33,500.60
|
| Rate for Payer: United Healthcare Medicaid |
$33,500.60
|
|
|
ACUTE LEUKEMIA
|
Facility
|
OP
|
$133.65
|
|
|
Service Code
|
EAPG 00800
|
| Min. Negotiated Rate |
$128.51 |
| Max. Negotiated Rate |
$133.65 |
| Rate for Payer: Anthem Medicaid |
$128.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$128.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$128.51
|
| Rate for Payer: Dean Health Medicaid |
$128.51
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$128.51
|
| Rate for Payer: Managed Health Services Medicaid |
$133.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$128.51
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$128.51
|
| Rate for Payer: United Healthcare Medicaid |
$128.51
|
|
|
ACUTE LEUKEMIA WITH CC
|
Facility
|
IP
|
$62,143.12
|
|
|
Service Code
|
MSDRG 835
|
| Min. Negotiated Rate |
$16,480.26 |
| Max. Negotiated Rate |
$62,143.12 |
| Rate for Payer: Aetna Managed Medicare |
$16,480.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$45,510.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$34,883.42
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33,141.53
|
| Rate for Payer: Anthem Medicare Advantage |
$16,480.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16,480.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16,480.26
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16,480.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36,790.13
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16,480.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$45,335.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16,480.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16,480.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16,480.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16,480.26
|
| Rate for Payer: NAPHCARE Commercial |
$24,720.38
|
| Rate for Payer: Quartz Medicare Advantage |
$16,480.26
|
| Rate for Payer: The Alliance Commercial |
$62,143.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,480.26
|
| Rate for Payer: United Healthcare PPO |
$35,294.62
|
| Rate for Payer: Wellcare Medicare |
$16,480.26
|
|
|
ACUTE LEUKEMIA WITH MCC
|
Facility
|
IP
|
$155,142.00
|
|
|
Service Code
|
MSDRG 834
|
| Min. Negotiated Rate |
$42,549.51 |
| Max. Negotiated Rate |
$155,142.00 |
| Rate for Payer: Aetna Managed Medicare |
$42,549.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$119,785.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$91,814.41
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$87,229.68
|
| Rate for Payer: Anthem Medicare Advantage |
$42,549.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$42,549.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$42,549.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$42,549.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$96,832.94
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$42,549.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113,547.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$42,549.51
|
| Rate for Payer: Independent Care Health Plan Medicare |
$42,549.51
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$42,549.51
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$42,549.51
|
| Rate for Payer: NAPHCARE Commercial |
$63,824.26
|
| Rate for Payer: Quartz Medicare Advantage |
$42,549.51
|
| Rate for Payer: The Alliance Commercial |
$155,142.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42,549.51
|
| Rate for Payer: United Healthcare PPO |
$88,398.36
|
| Rate for Payer: Wellcare Medicare |
$42,549.51
|
|
|
ACUTE LEUKEMIA WITH OTHER PROCEDURES
|
Facility
|
IP
|
$188,943.36
|
|
|
Service Code
|
MSDRG 850
|
| Min. Negotiated Rate |
$66,822.94 |
| Max. Negotiated Rate |
$188,943.36 |
| Rate for Payer: Aetna Managed Medicare |
$66,822.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$188,943.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$144,823.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$137,591.83
|
| Rate for Payer: Anthem Medicare Advantage |
$66,822.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$66,822.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$66,822.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$66,822.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$152,739.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$66,822.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$66,822.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$66,822.94
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$66,822.94
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$66,822.94
|
| Rate for Payer: NAPHCARE Commercial |
$100,234.41
|
| Rate for Payer: Quartz Medicare Advantage |
$66,822.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$66,822.94
|
| Rate for Payer: Wellcare Medicare |
$66,822.94
|
|
|
ACUTE LEUKEMIA WITHOUT CC/MCC
|
Facility
|
IP
|
$39,371.28
|
|
|
Service Code
|
MSDRG 836
|
| Min. Negotiated Rate |
$9,845.96 |
| Max. Negotiated Rate |
$39,371.28 |
| Rate for Payer: Aetna Managed Medicare |
$9,845.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$26,608.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,395.21
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,376.78
|
| Rate for Payer: Anthem Medicare Advantage |
$9,845.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,845.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,845.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,845.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21,510.00
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,845.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24,281.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,845.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,845.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,845.96
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,845.96
|
| Rate for Payer: NAPHCARE Commercial |
$14,768.94
|
| Rate for Payer: Quartz Medicare Advantage |
$9,845.96
|
| Rate for Payer: The Alliance Commercial |
$39,371.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,845.96
|
| Rate for Payer: United Healthcare PPO |
$18,903.26
|
| Rate for Payer: Wellcare Medicare |
$9,845.96
|
|
|
ACUTE LOWER URINARY TRACT INFECTIONS
|
Facility
|
OP
|
$102.20
|
|
|
Service Code
|
EAPG 00727
|
| 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
|
|
|
ACUTE MAJOR EYE INFECTIONS
|
Facility
|
OP
|
$85.17
|
|
|
Service Code
|
EAPG 00550
|
| Min. Negotiated Rate |
$81.89 |
| Max. Negotiated Rate |
$85.17 |
| Rate for Payer: Anthem Medicaid |
$81.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$81.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$81.89
|
| Rate for Payer: Dean Health Medicaid |
$81.89
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$81.89
|
| Rate for Payer: Managed Health Services Medicaid |
$85.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$81.89
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$81.89
|
| Rate for Payer: United Healthcare Medicaid |
$81.89
|
|
|
ACUTE MAJOR EYE INFECTIONS WITH CC/MCC
|
Facility
|
IP
|
$35,757.28
|
|
|
Service Code
|
MSDRG 121
|
| Min. Negotiated Rate |
$9,415.56 |
| Max. Negotiated Rate |
$35,757.28 |
| Rate for Payer: Aetna Managed Medicare |
$9,415.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25,382.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,455.31
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18,483.81
|
| Rate for Payer: Anthem Medicare Advantage |
$9,415.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,415.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,415.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,415.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20,518.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,415.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,982.74
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,415.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,415.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,415.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,415.56
|
| Rate for Payer: NAPHCARE Commercial |
$14,123.34
|
| Rate for Payer: Quartz Medicare Advantage |
$9,415.56
|
| Rate for Payer: The Alliance Commercial |
$35,757.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,415.56
|
| Rate for Payer: United Healthcare PPO |
$20,227.90
|
| Rate for Payer: Wellcare Medicare |
$9,415.56
|
|
|
ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$20,918.56
|
|
|
Service Code
|
MSDRG 122
|
| Min. Negotiated Rate |
$6,524.59 |
| Max. Negotiated Rate |
$20,918.56 |
| Rate for Payer: Aetna Managed Medicare |
$6,524.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,145.53
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13,141.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12,485.67
|
| Rate for Payer: Anthem Medicare Advantage |
$6,524.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,524.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,524.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,524.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13,860.24
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,524.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,098.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,524.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,524.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,524.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,524.59
|
| Rate for Payer: NAPHCARE Commercial |
$9,786.88
|
| Rate for Payer: Quartz Medicare Advantage |
$6,524.59
|
| Rate for Payer: The Alliance Commercial |
$20,918.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,524.59
|
| Rate for Payer: United Healthcare PPO |
$11,754.34
|
| Rate for Payer: Wellcare Medicare |
$6,524.59
|
|
|
ACUTE MYOCARDIAL INFARCTION
|
Facility
|
IP
|
$11,223.44
|
|
|
Service Code
|
APR-DRG 1903
|
| Min. Negotiated Rate |
$9,969.36 |
| Max. Negotiated Rate |
$11,223.44 |
| Rate for Payer: Anthem Medicaid |
$10,747.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,747.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,747.06
|
| Rate for Payer: Dean Health Medicaid |
$10,747.06
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,969.36
|
| Rate for Payer: Managed Health Services Medicaid |
$11,223.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,747.06
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,747.06
|
| Rate for Payer: United Healthcare Medicaid |
$10,747.06
|
|
|
ACUTE MYOCARDIAL INFARCTION
|
Facility
|
IP
|
$18,764.18
|
|
|
Service Code
|
APR-DRG 1904
|
| Min. Negotiated Rate |
$16,667.52 |
| Max. Negotiated Rate |
$18,764.18 |
| Rate for Payer: Anthem Medicaid |
$17,967.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,967.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,967.74
|
| Rate for Payer: Dean Health Medicaid |
$17,967.74
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,667.52
|
| Rate for Payer: Managed Health Services Medicaid |
$18,764.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,967.74
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,967.74
|
| Rate for Payer: United Healthcare Medicaid |
$17,967.74
|
|
|
ACUTE MYOCARDIAL INFARCTION
|
Facility
|
IP
|
$8,417.58
|
|
|
Service Code
|
APR-DRG 1902
|
| Min. Negotiated Rate |
$7,477.02 |
| Max. Negotiated Rate |
$8,417.58 |
| Rate for Payer: Anthem Medicaid |
$8,060.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$8,060.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8,060.29
|
| Rate for Payer: Dean Health Medicaid |
$8,060.29
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,477.02
|
| Rate for Payer: Managed Health Services Medicaid |
$8,417.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,060.29
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8,060.29
|
| Rate for Payer: United Healthcare Medicaid |
$8,060.29
|
|
|
ACUTE MYOCARDIAL INFARCTION
|
Facility
|
OP
|
$192.61
|
|
|
Service Code
|
EAPG 00591
|
| Min. Negotiated Rate |
$185.21 |
| Max. Negotiated Rate |
$192.61 |
| Rate for Payer: Anthem Medicaid |
$185.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$185.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$185.21
|
| Rate for Payer: Dean Health Medicaid |
$185.21
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$185.21
|
| Rate for Payer: Managed Health Services Medicaid |
$192.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$185.21
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$185.21
|
| Rate for Payer: United Healthcare Medicaid |
$185.21
|
|
|
ACUTE MYOCARDIAL INFARCTION
|
Facility
|
IP
|
$7,277.70
|
|
|
Service Code
|
APR-DRG 1901
|
| Min. Negotiated Rate |
$6,464.50 |
| Max. Negotiated Rate |
$7,277.70 |
| Rate for Payer: Anthem Medicaid |
$6,968.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,968.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,968.80
|
| Rate for Payer: Dean Health Medicaid |
$6,968.80
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,464.50
|
| Rate for Payer: Managed Health Services Medicaid |
$7,277.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,968.80
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,968.80
|
| Rate for Payer: United Healthcare Medicaid |
$6,968.80
|
|
|
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC
|
Facility
|
IP
|
$25,576.72
|
|
|
Service Code
|
MSDRG 281
|
| Min. Negotiated Rate |
$7,545.44 |
| Max. Negotiated Rate |
$25,576.72 |
| Rate for Payer: Aetna Managed Medicare |
$7,545.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,054.03
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,371.25
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,603.69
|
| Rate for Payer: Anthem Medicare Advantage |
$7,545.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,545.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,545.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,545.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,211.44
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,545.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18,515.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,545.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,545.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,545.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,545.44
|
| Rate for Payer: NAPHCARE Commercial |
$11,318.16
|
| Rate for Payer: Quartz Medicare Advantage |
$7,545.44
|
| Rate for Payer: The Alliance Commercial |
$25,576.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,545.44
|
| Rate for Payer: United Healthcare PPO |
$14,414.66
|
| Rate for Payer: Wellcare Medicare |
$7,545.44
|
|
|
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC
|
Facility
|
IP
|
$44,198.96
|
|
|
Service Code
|
MSDRG 280
|
| Min. Negotiated Rate |
$12,791.28 |
| Max. Negotiated Rate |
$44,198.96 |
| Rate for Payer: Aetna Managed Medicare |
$12,791.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$35,000.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,827.35
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25,487.74
|
| Rate for Payer: Anthem Medicare Advantage |
$12,791.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,791.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,791.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,791.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28,293.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,791.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,174.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,791.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,791.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,791.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,791.28
|
| Rate for Payer: NAPHCARE Commercial |
$19,186.92
|
| Rate for Payer: Quartz Medicare Advantage |
$12,791.28
|
| Rate for Payer: The Alliance Commercial |
$44,198.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,791.28
|
| Rate for Payer: United Healthcare PPO |
$25,048.05
|
| Rate for Payer: Wellcare Medicare |
$12,791.28
|
|
|
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC
|
Facility
|
IP
|
$20,188.48
|
|
|
Service Code
|
MSDRG 282
|
| Min. Negotiated Rate |
$6,044.43 |
| Max. Negotiated Rate |
$20,188.48 |
| Rate for Payer: Aetna Managed Medicare |
$6,044.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15,777.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$12,093.30
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11,489.42
|
| Rate for Payer: Anthem Medicare Advantage |
$6,044.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,044.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,044.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,044.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,754.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,044.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,563.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,044.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,044.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,044.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,044.43
|
| Rate for Payer: NAPHCARE Commercial |
$9,066.64
|
| Rate for Payer: Quartz Medicare Advantage |
$6,044.43
|
| Rate for Payer: The Alliance Commercial |
$20,188.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,044.43
|
| Rate for Payer: United Healthcare PPO |
$11,337.54
|
| Rate for Payer: Wellcare Medicare |
$6,044.43
|
|
