|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
OP
|
$29.54
|
|
|
Service Code
|
EAPG 00721
|
| Min. Negotiated Rate |
$28.41 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Anthem Medicaid |
$28.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$28.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.41
|
| Rate for Payer: Dean Health Medicaid |
$28.41
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$28.41
|
| Rate for Payer: Managed Health Services Medicaid |
$29.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$28.41
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$28.41
|
| Rate for Payer: United Healthcare Medicaid |
$28.41
|
|
|
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 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 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
|
$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
|
$14,643.08
|
|
|
Service Code
|
APR-DRG 4422
|
| Min. Negotiated Rate |
$13,006.90 |
| Max. Negotiated Rate |
$14,643.08 |
| Rate for Payer: Anthem Medicaid |
$14,021.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$14,021.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14,021.55
|
| Rate for Payer: Dean Health Medicaid |
$14,021.55
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$13,006.90
|
| Rate for Payer: Managed Health Services Medicaid |
$14,643.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,021.55
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14,021.55
|
| Rate for Payer: United Healthcare Medicaid |
$14,021.55
|
|
|
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
|
|
|
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 NON-MALIGNANCY
|
Facility
|
IP
|
$11,837.22
|
|
|
Service Code
|
APR-DRG 4431
|
| 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
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$14,204.66
|
|
|
Service Code
|
APR-DRG 4432
|
| Min. Negotiated Rate |
$12,617.47 |
| Max. Negotiated Rate |
$14,204.66 |
| Rate for Payer: Anthem Medicaid |
$13,601.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$13,601.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13,601.75
|
| Rate for Payer: Dean Health Medicaid |
$13,601.75
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12,617.47
|
| Rate for Payer: Managed Health Services Medicaid |
$14,204.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,601.75
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13,601.75
|
| Rate for Payer: United Healthcare Medicaid |
$13,601.75
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$31,916.65
|
|
|
Service Code
|
APR-DRG 4434
|
| Min. Negotiated Rate |
$28,350.36 |
| Max. Negotiated Rate |
$31,916.65 |
| Rate for Payer: Anthem Medicaid |
$30,561.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$30,561.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$30,561.95
|
| Rate for Payer: Dean Health Medicaid |
$30,561.95
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$28,350.36
|
| Rate for Payer: Managed Health Services Medicaid |
$31,916.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$30,561.95
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$30,561.95
|
| Rate for Payer: United Healthcare Medicaid |
$30,561.95
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$19,377.97
|
|
|
Service Code
|
APR-DRG 4433
|
| Min. Negotiated Rate |
$17,212.72 |
| Max. Negotiated Rate |
$19,377.97 |
| Rate for Payer: Anthem Medicaid |
$18,555.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$18,555.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18,555.47
|
| Rate for Payer: Dean Health Medicaid |
$18,555.47
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17,212.72
|
| Rate for Payer: Managed Health Services Medicaid |
$19,377.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$18,555.47
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18,555.47
|
| Rate for Payer: United Healthcare Medicaid |
$18,555.47
|
|
|
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$33,401.68
|
|
|
Service Code
|
MSDRG 695
|
| Min. Negotiated Rate |
$9,266.22 |
| Max. Negotiated Rate |
$33,401.68 |
| Rate for Payer: Aetna Managed Medicare |
$9,266.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24,956.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,129.19
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18,173.98
|
| Rate for Payer: Anthem Medicare Advantage |
$9,266.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,266.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,266.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,266.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20,174.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,266.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24,254.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,266.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,266.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,266.22
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,266.22
|
| Rate for Payer: NAPHCARE Commercial |
$13,899.33
|
| Rate for Payer: Quartz Medicare Advantage |
$9,266.22
|
| Rate for Payer: The Alliance Commercial |
$33,401.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,266.22
|
| Rate for Payer: United Healthcare PPO |
$18,882.74
|
| Rate for Payer: Wellcare Medicare |
$9,266.22
|
|
|
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$19,469.84
|
|
|
Service Code
|
MSDRG 696
|
| Min. Negotiated Rate |
$5,783.27 |
| Max. Negotiated Rate |
$19,469.84 |
| Rate for Payer: Aetna Managed Medicare |
$5,783.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15,033.43
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,523.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,947.60
|
| Rate for Payer: Anthem Medicare Advantage |
$5,783.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,783.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,783.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,783.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,152.84
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,783.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,035.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,783.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,783.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,783.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,783.27
|
| Rate for Payer: NAPHCARE Commercial |
$8,674.91
|
| Rate for Payer: Quartz Medicare Advantage |
$5,783.27
|
| Rate for Payer: The Alliance Commercial |
$19,469.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,783.27
|
| Rate for Payer: United Healthcare PPO |
$10,927.04
|
| Rate for Payer: Wellcare Medicare |
$5,783.27
|
|
|
KIDNEY ENDOSCOPY AND BIOPSY 50555
|
Professional
|
Both
|
$2,214.00
|
|
|
Service Code
|
CPT 50555
|
| Hospital Charge Code |
3014940
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$228.61 |
| Max. Negotiated Rate |
$2,187.43 |
| Rate for Payer: Aetna Commercial |
$2,187.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.20
|
| Rate for Payer: Aetna Managed Medicare |
$289.60
|
| Rate for Payer: Anthem Medicare Advantage |
$289.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$289.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$289.60
|
| Rate for Payer: Cash Price |
$664.20
|
| Rate for Payer: Cash Price |
$664.20
|
| Rate for Payer: Cash Price |
$664.20
|
| Rate for Payer: Cigna Commercial |
$2,187.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$228.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$289.60
|
| Rate for Payer: Health EOS Commercial |
$2,095.33
|
| Rate for Payer: HFN Commercial |
$2,187.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,177.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,177.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$289.60
|
| Rate for Payer: Multiplan Commercial |
$1,842.05
|
| Rate for Payer: NAPHCARE Commercial |
$434.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,187.43
|
| Rate for Payer: Quartz Beloit One Network |
$1,013.13
|
| Rate for Payer: Quartz Commercial |
$1,312.46
|
| Rate for Payer: Quartz Medicare Advantage |
$289.60
|
| Rate for Payer: The Alliance Commercial |
$1,230.79
|
| Rate for Payer: United Healthcare Medicaid |
$228.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$289.60
|
| Rate for Payer: WEA Trust Commercial |
$1,266.41
|
| Rate for Payer: WPS Commercial |
$1,303.19
|
|
|
KIDNEY TRANSPLANT
|
Facility
|
IP
|
$53,135.96
|
|
|
Service Code
|
APR-DRG 4403
|
| Min. Negotiated Rate |
$47,198.67 |
| Max. Negotiated Rate |
$53,135.96 |
| Rate for Payer: Anthem Medicaid |
$50,880.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$50,880.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50,880.61
|
| Rate for Payer: Dean Health Medicaid |
$50,880.61
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$47,198.67
|
| Rate for Payer: Managed Health Services Medicaid |
$53,135.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$50,880.61
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$50,880.61
|
| Rate for Payer: United Healthcare Medicaid |
$50,880.61
|
|
|
KIDNEY TRANSPLANT
|
Facility
|
IP
|
$78,125.64
|
|
|
Service Code
|
APR-DRG 4404
|
| Min. Negotiated Rate |
$69,396.07 |
| Max. Negotiated Rate |
$78,125.64 |
| Rate for Payer: Anthem Medicaid |
$74,809.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$74,809.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$74,809.61
|
| Rate for Payer: Dean Health Medicaid |
$74,809.61
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$69,396.07
|
| Rate for Payer: Managed Health Services Medicaid |
$78,125.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$74,809.61
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$74,809.61
|
| Rate for Payer: United Healthcare Medicaid |
$74,809.61
|
|
|
KIDNEY TRANSPLANT
|
Facility
|
IP
|
$83,402.80
|
|
|
Service Code
|
MSDRG 652
|
| Min. Negotiated Rate |
$25,238.93 |
| Max. Negotiated Rate |
$83,402.80 |
| Rate for Payer: Aetna Managed Medicare |
$25,238.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$70,465.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$54,010.93
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$51,313.91
|
| Rate for Payer: Anthem Medicare Advantage |
$25,238.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25,238.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25,238.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$25,238.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$56,963.15
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$25,238.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25,238.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25,238.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$25,238.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$25,238.93
|
| Rate for Payer: NAPHCARE Commercial |
$37,858.39
|
| Rate for Payer: Quartz Medicare Advantage |
$25,238.93
|
| Rate for Payer: The Alliance Commercial |
$83,402.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,238.93
|
| Rate for Payer: Wellcare Medicare |
$25,238.93
|
|
|
KIDNEY TRANSPLANT
|
Facility
|
IP
|
$45,244.48
|
|
|
Service Code
|
APR-DRG 4402
|
| Min. Negotiated Rate |
$40,188.97 |
| Max. Negotiated Rate |
$45,244.48 |
| Rate for Payer: Anthem Medicaid |
$43,324.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$43,324.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43,324.08
|
| Rate for Payer: Dean Health Medicaid |
$43,324.08
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$40,188.97
|
| Rate for Payer: Managed Health Services Medicaid |
$45,244.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$43,324.08
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$43,324.08
|
| Rate for Payer: United Healthcare Medicaid |
$43,324.08
|
|
|
KIDNEY TRANSPLANT
|
Facility
|
IP
|
$42,350.94
|
|
|
Service Code
|
APR-DRG 4401
|
| Min. Negotiated Rate |
$37,618.74 |
| Max. Negotiated Rate |
$42,350.94 |
| Rate for Payer: Anthem Medicaid |
$40,553.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$40,553.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$40,553.36
|
| Rate for Payer: Dean Health Medicaid |
$40,553.36
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$37,618.74
|
| Rate for Payer: Managed Health Services Medicaid |
$42,350.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$40,553.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$40,553.36
|
| Rate for Payer: United Healthcare Medicaid |
$40,553.36
|
|
|
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC
|
Facility
|
IP
|
$124,686.64
|
|
|
Service Code
|
MSDRG 650
|
| Min. Negotiated Rate |
$36,511.02 |
| Max. Negotiated Rate |
$124,686.64 |
| Rate for Payer: Aetna Managed Medicare |
$36,511.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$102,580.79
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$78,627.34
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$74,701.11
|
| Rate for Payer: Anthem Medicare Advantage |
$36,511.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36,511.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36,511.02
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$36,511.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$82,925.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$36,511.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$91,209.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$36,511.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36,511.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$36,511.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$36,511.02
|
| Rate for Payer: NAPHCARE Commercial |
$54,766.53
|
| Rate for Payer: Quartz Medicare Advantage |
$36,511.02
|
| Rate for Payer: The Alliance Commercial |
$124,686.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,511.02
|
| Rate for Payer: United Healthcare PPO |
$71,007.61
|
| Rate for Payer: Wellcare Medicare |
$36,511.02
|
|
