|
KIDNER PROCEDURE
|
Facility
|
IP
|
$1,632.00
|
|
| Hospital Charge Code |
2960164
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$831.67 |
| Max. Negotiated Rate |
$1,561.50 |
| Rate for Payer: Aetna Commercial |
$1,527.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,459.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$899.56
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cigna Commercial |
$1,561.50
|
| Rate for Payer: Health EOS Commercial |
$1,510.58
|
| Rate for Payer: HFN Commercial |
$1,561.50
|
| Rate for Payer: Multiplan Commercial |
$1,357.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,561.50
|
| Rate for Payer: Quartz Beloit One Network |
$831.67
|
| Rate for Payer: Quartz Commercial |
$1,018.37
|
| Rate for Payer: WEA Trust Commercial |
$933.50
|
| Rate for Payer: WPS Commercial |
$1,257.13
|
|
|
KIDNER PROCEDURE
|
Facility
|
OP
|
$1,632.00
|
|
| Hospital Charge Code |
2960164
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$475.24 |
| Max. Negotiated Rate |
$1,561.50 |
| Rate for Payer: Aetna Commercial |
$1,527.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,459.66
|
| Rate for Payer: Aetna Managed Medicare |
$475.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,103.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$848.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$814.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$899.56
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cigna Commercial |
$1,561.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$949.82
|
| Rate for Payer: Health EOS Commercial |
$1,510.58
|
| Rate for Payer: HFN Commercial |
$1,561.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,272.96
|
| Rate for Payer: Multiplan Commercial |
$1,357.82
|
| Rate for Payer: NAPHCARE Commercial |
$1,018.37
|
| Rate for Payer: Preferred Network Access Commercial |
$1,561.50
|
| Rate for Payer: Quartz Beloit One Network |
$831.67
|
| Rate for Payer: Quartz Commercial |
$1,103.23
|
| Rate for Payer: Quartz Medicare Advantage |
$1,018.37
|
| Rate for Payer: The Alliance Commercial |
$848.64
|
| Rate for Payer: WEA Trust Commercial |
$933.50
|
| Rate for Payer: WPS Commercial |
$1,257.13
|
|
|
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC
|
Facility
|
IP
|
$51,324.00
|
|
|
Service Code
|
MSDRG 657
|
| Min. Negotiated Rate |
$14,521.28 |
| Max. Negotiated Rate |
$51,324.00 |
| Rate for Payer: Aetna Managed Medicare |
$14,521.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$39,929.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30,605.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29,077.09
|
| Rate for Payer: Anthem Medicare Advantage |
$14,521.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,521.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,521.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,521.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32,278.24
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,521.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37,400.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,521.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,521.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,521.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,521.28
|
| Rate for Payer: NAPHCARE Commercial |
$21,781.92
|
| Rate for Payer: Quartz Medicare Advantage |
$14,521.28
|
| Rate for Payer: The Alliance Commercial |
$51,324.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,521.28
|
| Rate for Payer: United Healthcare PPO |
$29,116.67
|
| Rate for Payer: Wellcare Medicare |
$14,521.28
|
|
|
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC
|
Facility
|
IP
|
$87,086.48
|
|
|
Service Code
|
MSDRG 656
|
| Min. Negotiated Rate |
$24,888.95 |
| Max. Negotiated Rate |
$87,086.48 |
| Rate for Payer: Aetna Managed Medicare |
$24,888.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$69,467.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$53,246.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$50,587.78
|
| Rate for Payer: Anthem Medicare Advantage |
$24,888.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24,888.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24,888.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$24,888.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$56,157.07
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$24,888.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63,630.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24,888.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24,888.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$24,888.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$24,888.95
|
| Rate for Payer: NAPHCARE Commercial |
$37,333.42
|
| Rate for Payer: Quartz Medicare Advantage |
$24,888.95
|
| Rate for Payer: The Alliance Commercial |
$87,086.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,888.95
|
| Rate for Payer: United Healthcare PPO |
$49,537.19
|
| Rate for Payer: Wellcare Medicare |
$24,888.95
|
|
|
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$41,265.12
|
|
|
Service Code
|
MSDRG 658
|
| Min. Negotiated Rate |
$12,390.78 |
| Max. Negotiated Rate |
$41,265.12 |
| Rate for Payer: Aetna Managed Medicare |
$12,390.78
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33,859.03
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25,952.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,656.74
|
| Rate for Payer: Anthem Medicare Advantage |
$12,390.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,390.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,390.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,390.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27,371.24
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,390.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,022.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,390.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,390.78
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,390.78
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,390.78
|
| Rate for Payer: NAPHCARE Commercial |
$18,586.17
|
| Rate for Payer: Quartz Medicare Advantage |
$12,390.78
|
| Rate for Payer: The Alliance Commercial |
$41,265.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,390.78
|
| Rate for Payer: United Healthcare PPO |
$23,372.91
|
| Rate for Payer: Wellcare Medicare |
$12,390.78
|
|
|
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC
|
Facility
|
IP
|
$37,546.08
|
|
|
Service Code
|
MSDRG 660
|
| Min. Negotiated Rate |
$10,628.61 |
| Max. Negotiated Rate |
$37,546.08 |
| Rate for Payer: Aetna Managed Medicare |
$10,628.61
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$28,838.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22,104.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21,000.65
|
| Rate for Payer: Anthem Medicare Advantage |
$10,628.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,628.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,628.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,628.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23,312.65
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,628.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$27,294.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,628.61
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,628.61
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,628.61
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,628.61
|
| Rate for Payer: NAPHCARE Commercial |
$15,942.92
|
| Rate for Payer: Quartz Medicare Advantage |
$10,628.61
|
| Rate for Payer: The Alliance Commercial |
$37,546.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,628.61
|
| Rate for Payer: United Healthcare PPO |
$21,249.39
|
| Rate for Payer: Wellcare Medicare |
$10,628.61
|
|
|
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
|
Facility
|
IP
|
$71,914.96
|
|
|
Service Code
|
MSDRG 659
|
| Min. Negotiated Rate |
$19,965.49 |
| Max. Negotiated Rate |
$71,914.96 |
| Rate for Payer: Aetna Managed Medicare |
$19,965.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$55,440.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$42,494.62
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40,372.67
|
| Rate for Payer: Anthem Medicare Advantage |
$19,965.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19,965.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19,965.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$19,965.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$44,817.36
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$19,965.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$52,502.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19,965.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19,965.49
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$19,965.49
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$19,965.49
|
| Rate for Payer: NAPHCARE Commercial |
$29,948.24
|
| Rate for Payer: Quartz Medicare Advantage |
$19,965.49
|
| Rate for Payer: The Alliance Commercial |
$71,914.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,965.49
|
| Rate for Payer: United Healthcare PPO |
$40,874.17
|
| Rate for Payer: Wellcare Medicare |
$19,965.49
|
|
|
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$29,320.72
|
|
|
Service Code
|
MSDRG 661
|
| Min. Negotiated Rate |
$8,436.08 |
| Max. Negotiated Rate |
$29,320.72 |
| Rate for Payer: Aetna Managed Medicare |
$8,436.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22,591.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17,316.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,451.59
|
| Rate for Payer: Anthem Medicare Advantage |
$8,436.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,436.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,436.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,436.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,262.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,436.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,261.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,436.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,436.08
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,436.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,436.08
|
| Rate for Payer: NAPHCARE Commercial |
$12,654.13
|
| Rate for Payer: Quartz Medicare Advantage |
$8,436.08
|
| Rate for Payer: The Alliance Commercial |
$29,320.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,436.08
|
| Rate for Payer: United Healthcare PPO |
$16,552.39
|
| Rate for Payer: Wellcare Medicare |
$8,436.08
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
IP
|
$4,559.52
|
|
|
Service Code
|
APR-DRG 4631
|
| Min. Negotiated Rate |
$4,050.05 |
| Max. Negotiated Rate |
$4,559.52 |
| Rate for Payer: Anthem Medicaid |
$4,365.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,365.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,365.99
|
| Rate for Payer: Dean Health Medicaid |
$4,365.99
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,050.05
|
| Rate for Payer: Managed Health Services Medicaid |
$4,559.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,365.99
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,365.99
|
| Rate for Payer: United Healthcare Medicaid |
$4,365.99
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
IP
|
$7,979.16
|
|
|
Service Code
|
APR-DRG 4633
|
| Min. Negotiated Rate |
$7,087.59 |
| Max. Negotiated Rate |
$7,979.16 |
| Rate for Payer: Anthem Medicaid |
$7,640.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,640.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,640.49
|
| Rate for Payer: Dean Health Medicaid |
$7,640.49
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,087.59
|
| Rate for Payer: Managed Health Services Medicaid |
$7,979.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,640.49
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,640.49
|
| Rate for Payer: United Healthcare Medicaid |
$7,640.49
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
IP
|
$5,787.08
|
|
|
Service Code
|
APR-DRG 4632
|
| 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
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
IP
|
$13,240.15
|
|
|
Service Code
|
APR-DRG 4634
|
| Min. Negotiated Rate |
$11,760.73 |
| Max. Negotiated Rate |
$13,240.15 |
| Rate for Payer: Anthem Medicaid |
$12,678.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,678.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,678.17
|
| Rate for Payer: Dean Health Medicaid |
$12,678.17
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,760.73
|
| Rate for Payer: Managed Health Services Medicaid |
$13,240.15
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,678.17
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,678.17
|
| Rate for Payer: United Healthcare Medicaid |
$12,678.17
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC
|
Facility
|
IP
|
$32,804.72
|
|
|
Service Code
|
MSDRG 689
|
| Min. Negotiated Rate |
$9,392.59 |
| Max. Negotiated Rate |
$32,804.72 |
| Rate for Payer: Aetna Managed Medicare |
$9,392.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25,316.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,405.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18,436.15
|
| Rate for Payer: Anthem Medicare Advantage |
$9,392.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,392.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,392.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,392.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20,465.81
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,392.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23,816.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,392.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,392.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,392.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,392.59
|
| Rate for Payer: NAPHCARE Commercial |
$14,088.89
|
| Rate for Payer: Quartz Medicare Advantage |
$9,392.59
|
| Rate for Payer: The Alliance Commercial |
$32,804.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,392.59
|
| Rate for Payer: United Healthcare PPO |
$18,541.71
|
| Rate for Payer: Wellcare Medicare |
$9,392.59
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC
|
Facility
|
IP
|
$22,643.92
|
|
|
Service Code
|
MSDRG 690
|
| Min. Negotiated Rate |
$6,706.10 |
| Max. Negotiated Rate |
$22,643.92 |
| Rate for Payer: Aetna Managed Medicare |
$6,706.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,662.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13,538.27
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12,862.24
|
| Rate for Payer: Anthem Medicare Advantage |
$6,706.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,706.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,706.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,706.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14,278.27
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,706.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16,363.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,706.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,706.10
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,706.10
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,706.10
|
| Rate for Payer: NAPHCARE Commercial |
$10,059.15
|
| Rate for Payer: Quartz Medicare Advantage |
$6,706.10
|
| Rate for Payer: The Alliance Commercial |
$22,643.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,706.10
|
| Rate for Payer: United Healthcare PPO |
$12,739.53
|
| Rate for Payer: Wellcare Medicare |
$6,706.10
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
OP
|
$98.27
|
|
|
Service Code
|
EAPG 00721
|
| Min. Negotiated Rate |
$94.49 |
| Max. Negotiated Rate |
$98.27 |
| Rate for Payer: Anthem Medicaid |
$94.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$94.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$94.49
|
| Rate for Payer: Dean Health Medicaid |
$94.49
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$94.49
|
| Rate for Payer: Managed Health Services Medicaid |
$98.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$94.49
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$94.49
|
| Rate for Payer: United Healthcare Medicaid |
$94.49
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
IP
|
$6,663.92
|
|
|
Service Code
|
APR-DRG 4611
|
| Min. Negotiated Rate |
$5,919.31 |
| Max. Negotiated Rate |
$6,663.92 |
| Rate for Payer: Anthem Medicaid |
$6,381.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,381.07
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,381.07
|
| Rate for Payer: Dean Health Medicaid |
$6,381.07
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,919.31
|
| Rate for Payer: Managed Health Services Medicaid |
$6,663.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,381.07
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,381.07
|
| Rate for Payer: United Healthcare Medicaid |
$6,381.07
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
IP
|
$20,780.89
|
|
|
Service Code
|
APR-DRG 4614
|
| Min. Negotiated Rate |
$18,458.89 |
| Max. Negotiated Rate |
$20,780.89 |
| Rate for Payer: Anthem Medicaid |
$19,898.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$19,898.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19,898.85
|
| Rate for Payer: Dean Health Medicaid |
$19,898.85
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,458.89
|
| Rate for Payer: Managed Health Services Medicaid |
$20,780.89
|
| Rate for Payer: Molina Healthcare Medicaid |
$19,898.85
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19,898.85
|
| Rate for Payer: United Healthcare Medicaid |
$19,898.85
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
IP
|
$12,100.27
|
|
|
Service Code
|
APR-DRG 4613
|
| Min. Negotiated Rate |
$10,748.21 |
| Max. Negotiated Rate |
$12,100.27 |
| Rate for Payer: Anthem Medicaid |
$11,586.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$11,586.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11,586.67
|
| Rate for Payer: Dean Health Medicaid |
$11,586.67
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,748.21
|
| Rate for Payer: Managed Health Services Medicaid |
$12,100.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,586.67
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11,586.67
|
| Rate for Payer: United Healthcare Medicaid |
$11,586.67
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
IP
|
$7,979.16
|
|
|
Service Code
|
APR-DRG 4612
|
| Min. Negotiated Rate |
$7,087.59 |
| Max. Negotiated Rate |
$7,979.16 |
| Rate for Payer: Anthem Medicaid |
$7,640.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,640.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,640.49
|
| Rate for Payer: Dean Health Medicaid |
$7,640.49
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,087.59
|
| Rate for Payer: Managed Health Services Medicaid |
$7,979.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,640.49
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,640.49
|
| Rate for Payer: United Healthcare Medicaid |
$7,640.49
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITH CC
|
Facility
|
IP
|
$29,235.44
|
|
|
Service Code
|
MSDRG 687
|
| Min. Negotiated Rate |
$8,531.04 |
| Max. Negotiated Rate |
$29,235.44 |
| Rate for Payer: Aetna Managed Medicare |
$8,531.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22,862.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17,523.66
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,648.62
|
| Rate for Payer: Anthem Medicare Advantage |
$8,531.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,531.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,531.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,531.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,481.49
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,531.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,198.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,531.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,531.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,531.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,531.04
|
| Rate for Payer: NAPHCARE Commercial |
$12,796.56
|
| Rate for Payer: Quartz Medicare Advantage |
$8,531.04
|
| Rate for Payer: The Alliance Commercial |
$29,235.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,531.04
|
| Rate for Payer: United Healthcare PPO |
$16,503.45
|
| Rate for Payer: Wellcare Medicare |
$8,531.04
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC
|
Facility
|
IP
|
$51,191.92
|
|
|
Service Code
|
MSDRG 686
|
| Min. Negotiated Rate |
$14,319.87 |
| Max. Negotiated Rate |
$51,191.92 |
| Rate for Payer: Aetna Managed Medicare |
$14,319.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$39,355.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30,165.51
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28,659.21
|
| Rate for Payer: Anthem Medicare Advantage |
$14,319.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,319.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,319.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,319.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31,814.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,319.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37,303.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,319.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,319.87
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,319.87
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,319.87
|
| Rate for Payer: NAPHCARE Commercial |
$21,479.81
|
| Rate for Payer: Quartz Medicare Advantage |
$14,319.87
|
| Rate for Payer: The Alliance Commercial |
$51,191.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,319.87
|
| Rate for Payer: United Healthcare PPO |
$29,040.89
|
| Rate for Payer: Wellcare Medicare |
$14,319.87
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC
|
Facility
|
IP
|
$21,924.24
|
|
|
Service Code
|
MSDRG 688
|
| Min. Negotiated Rate |
$6,559.05 |
| Max. Negotiated Rate |
$21,924.24 |
| Rate for Payer: Aetna Managed Medicare |
$6,559.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,243.71
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13,217.17
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12,557.17
|
| Rate for Payer: Anthem Medicare Advantage |
$6,559.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,559.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,559.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,559.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13,939.61
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,559.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,836.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,559.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,559.05
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,559.05
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,559.05
|
| Rate for Payer: NAPHCARE Commercial |
$9,838.58
|
| Rate for Payer: Quartz Medicare Advantage |
$6,559.05
|
| Rate for Payer: The Alliance Commercial |
$21,924.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,559.05
|
| Rate for Payer: United Healthcare PPO |
$12,329.03
|
| Rate for Payer: Wellcare Medicare |
$6,559.05
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$12,451.00
|
|
|
Service Code
|
APR-DRG 4421
|
| Min. Negotiated Rate |
$11,059.76 |
| Max. Negotiated Rate |
$12,451.00 |
| Rate for Payer: Anthem Medicaid |
$11,922.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$11,922.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11,922.52
|
| Rate for Payer: Dean Health Medicaid |
$11,922.52
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,059.76
|
| Rate for Payer: Managed Health Services Medicaid |
$12,451.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,922.52
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11,922.52
|
| Rate for Payer: United Healthcare Medicaid |
$11,922.52
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$22,446.87
|
|
|
Service Code
|
APR-DRG 4423
|
| Min. Negotiated Rate |
$19,938.71 |
| Max. Negotiated Rate |
$22,446.87 |
| Rate for Payer: Anthem Medicaid |
$21,494.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21,494.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,494.12
|
| Rate for Payer: Dean Health Medicaid |
$21,494.12
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19,938.71
|
| Rate for Payer: Managed Health Services Medicaid |
$22,446.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$21,494.12
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21,494.12
|
| Rate for Payer: United Healthcare Medicaid |
$21,494.12
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$37,353.00
|
|
|
Service Code
|
APR-DRG 4424
|
| Min. Negotiated Rate |
$33,179.27 |
| Max. Negotiated Rate |
$37,353.00 |
| Rate for Payer: Anthem Medicaid |
$35,767.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$35,767.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$35,767.56
|
| Rate for Payer: Dean Health Medicaid |
$35,767.56
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$33,179.27
|
| Rate for Payer: Managed Health Services Medicaid |
$37,353.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$35,767.56
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$35,767.56
|
| Rate for Payer: United Healthcare Medicaid |
$35,767.56
|
|
