Madison Medical Center

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$124,860.73

Service Code	APR-DRG 6134
Min. Negotiated Rate	$124,860.73
Max. Negotiated Rate	$124,860.73
Rate for Payer: Aetna Better Health Medicaid/QHP	$124,860.73
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$124,860.73
Rate for Payer: Home State Health Plan Medicaid Managed Care	$124,860.73
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$124,860.73

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$92,073.86

Service Code	APR-DRG 6133
Min. Negotiated Rate	$92,073.86
Max. Negotiated Rate	$92,073.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$92,073.86
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$92,073.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$92,073.86
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$92,073.86

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$65,844.06

Service Code	APR-DRG 6112
Min. Negotiated Rate	$65,844.06
Max. Negotiated Rate	$65,844.06
Rate for Payer: Aetna Better Health Medicaid/QHP	$65,844.06
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$65,844.06
Rate for Payer: Home State Health Plan Medicaid Managed Care	$65,844.06
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$65,844.06

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$113,112.40

Service Code	APR-DRG 6113
Min. Negotiated Rate	$113,112.40
Max. Negotiated Rate	$113,112.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$113,112.40
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$113,112.40
Rate for Payer: Home State Health Plan Medicaid Managed Care	$113,112.40
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$113,112.40

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$33,173.50

Service Code	APR-DRG 6111
Min. Negotiated Rate	$33,173.50
Max. Negotiated Rate	$33,173.50
Rate for Payer: Aetna Better Health Medicaid/QHP	$33,173.50
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$33,173.50
Rate for Payer: Home State Health Plan Medicaid Managed Care	$33,173.50
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$33,173.50

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$195,627.30

Service Code	APR-DRG 6114
Min. Negotiated Rate	$195,627.30
Max. Negotiated Rate	$195,627.30
Rate for Payer: Aetna Better Health Medicaid/QHP	$195,627.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$195,627.30
Rate for Payer: Home State Health Plan Medicaid Managed Care	$195,627.30
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$195,627.30

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$94,514.69

Service Code	APR-DRG 6144
Min. Negotiated Rate	$94,514.69
Max. Negotiated Rate	$94,514.69
Rate for Payer: Aetna Better Health Medicaid/QHP	$94,514.69
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$94,514.69
Rate for Payer: Home State Health Plan Medicaid Managed Care	$94,514.69
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$94,514.69

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$49,404.26

Service Code	APR-DRG 6142
Min. Negotiated Rate	$49,404.26
Max. Negotiated Rate	$49,404.26
Rate for Payer: Aetna Better Health Medicaid/QHP	$49,404.26
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$49,404.26
Rate for Payer: Home State Health Plan Medicaid Managed Care	$49,404.26
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$49,404.26

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$85,914.44

Service Code	APR-DRG 6143
Min. Negotiated Rate	$85,914.44
Max. Negotiated Rate	$85,914.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$85,914.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$85,914.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$85,914.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$85,914.44

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$31,263.90

Service Code	APR-DRG 6141
Min. Negotiated Rate	$31,263.90
Max. Negotiated Rate	$31,263.90
Rate for Payer: Aetna Better Health Medicaid/QHP	$31,263.90
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$31,263.90
Rate for Payer: Home State Health Plan Medicaid Managed Care	$31,263.90
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$31,263.90

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$44,109.26

Service Code	APR-DRG 6121
Min. Negotiated Rate	$44,109.26
Max. Negotiated Rate	$44,109.26
Rate for Payer: Aetna Better Health Medicaid/QHP	$44,109.26
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$44,109.26
Rate for Payer: Home State Health Plan Medicaid Managed Care	$44,109.26
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$44,109.26

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$100,392.78

Service Code	APR-DRG 6123
Min. Negotiated Rate	$100,392.78
Max. Negotiated Rate	$100,392.78
Rate for Payer: Aetna Better Health Medicaid/QHP	$100,392.78
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$100,392.78
Rate for Payer: Home State Health Plan Medicaid Managed Care	$100,392.78
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$100,392.78

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$80,044.21

Service Code	APR-DRG 6122
Min. Negotiated Rate	$80,044.21
Max. Negotiated Rate	$80,044.21
Rate for Payer: Aetna Better Health Medicaid/QHP	$80,044.21
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$80,044.21
Rate for Payer: Home State Health Plan Medicaid Managed Care	$80,044.21
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$80,044.21

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$169,714.97

Service Code	APR-DRG 6124
Min. Negotiated Rate	$169,714.97
Max. Negotiated Rate	$169,714.97
Rate for Payer: Aetna Better Health Medicaid/QHP	$169,714.97
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$169,714.97
Rate for Payer: Home State Health Plan Medicaid Managed Care	$169,714.97
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$169,714.97

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$196,086.23

Service Code	APR-DRG 6093
Min. Negotiated Rate	$196,086.23
Max. Negotiated Rate	$196,086.23
Rate for Payer: Aetna Better Health Medicaid/QHP	$196,086.23
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$196,086.23
Rate for Payer: Home State Health Plan Medicaid Managed Care	$196,086.23
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$196,086.23

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$97,216.41

Service Code	APR-DRG 6092
Min. Negotiated Rate	$97,216.41
Max. Negotiated Rate	$97,216.41
Rate for Payer: Aetna Better Health Medicaid/QHP	$97,216.41
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$97,216.41
Rate for Payer: Home State Health Plan Medicaid Managed Care	$97,216.41
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$97,216.41

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$494,380.53

Service Code	APR-DRG 6094
Min. Negotiated Rate	$494,380.53
Max. Negotiated Rate	$494,380.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$494,380.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$494,380.53
Rate for Payer: Home State Health Plan Medicaid Managed Care	$494,380.53
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$494,380.53

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$87,297.52

Service Code	APR-DRG 6091
Min. Negotiated Rate	$87,297.52
Max. Negotiated Rate	$87,297.52
Rate for Payer: Aetna Better Health Medicaid/QHP	$87,297.52
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$87,297.52
Rate for Payer: Home State Health Plan Medicaid Managed Care	$87,297.52
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$87,297.52

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$291,930.56

Service Code	APR-DRG 5881
Min. Negotiated Rate	$291,930.56
Max. Negotiated Rate	$291,930.56
Rate for Payer: Aetna Better Health Medicaid/QHP	$291,930.56
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$291,930.56
Rate for Payer: Home State Health Plan Medicaid Managed Care	$291,930.56
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$291,930.56

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$356,707.44

Service Code	APR-DRG 5882
Min. Negotiated Rate	$356,707.44
Max. Negotiated Rate	$356,707.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$356,707.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$356,707.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$356,707.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$356,707.44

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$356,707.44

Service Code	APR-DRG 5883
Min. Negotiated Rate	$356,707.44
Max. Negotiated Rate	$356,707.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$356,707.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$356,707.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$356,707.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$356,707.44

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$356,707.44

Service Code	APR-DRG 5884
Min. Negotiated Rate	$356,707.44
Max. Negotiated Rate	$356,707.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$356,707.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$356,707.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$356,707.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$356,707.44

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$4,400.71

Service Code	APR-DRG 6261
Min. Negotiated Rate	$4,400.71
Max. Negotiated Rate	$4,400.71
Rate for Payer: Aetna Better Health Medicaid/QHP	$4,400.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$4,400.71
Rate for Payer: Home State Health Plan Medicaid Managed Care	$4,400.71
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$4,400.71

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$20,274.70

Service Code	APR-DRG 6263
Min. Negotiated Rate	$20,274.70
Max. Negotiated Rate	$20,274.70
Rate for Payer: Aetna Better Health Medicaid/QHP	$20,274.70
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$20,274.70
Rate for Payer: Home State Health Plan Medicaid Managed Care	$20,274.70
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$20,274.70

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$41,429.55

Service Code	APR-DRG 6264
Min. Negotiated Rate	$41,429.55
Max. Negotiated Rate	$41,429.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$41,429.55
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$41,429.55
Rate for Payer: Home State Health Plan Medicaid Managed Care	$41,429.55
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$41,429.55

Know your out-of-pocket cost for care.

All Charges