Madison Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$7,613.23

Service Code	APR-DRG 6262
Min. Negotiated Rate	$7,613.23
Max. Negotiated Rate	$7,613.23
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,613.23
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,613.23
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,613.23
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,613.23

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$80,482.71

Service Code	APR-DRG 6234
Min. Negotiated Rate	$80,482.71
Max. Negotiated Rate	$80,482.71
Rate for Payer: Aetna Better Health Medicaid/QHP	$80,482.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$80,482.71
Rate for Payer: Home State Health Plan Medicaid Managed Care	$80,482.71
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$80,482.71

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$16,284.20

Service Code	APR-DRG 6231
Min. Negotiated Rate	$16,284.20
Max. Negotiated Rate	$16,284.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,284.20
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,284.20
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,284.20
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,284.20

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$60,934.12

Service Code	APR-DRG 6233
Min. Negotiated Rate	$60,934.12
Max. Negotiated Rate	$60,934.12
Rate for Payer: Aetna Better Health Medicaid/QHP	$60,934.12
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$60,934.12
Rate for Payer: Home State Health Plan Medicaid Managed Care	$60,934.12
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$60,934.12

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$30,272.17

Service Code	APR-DRG 6232
Min. Negotiated Rate	$30,272.17
Max. Negotiated Rate	$30,272.17
Rate for Payer: Aetna Better Health Medicaid/QHP	$30,272.17
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$30,272.17
Rate for Payer: Home State Health Plan Medicaid Managed Care	$30,272.17
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$30,272.17

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$46,333.19

Service Code	APR-DRG 6212
Min. Negotiated Rate	$46,333.19
Max. Negotiated Rate	$46,333.19
Rate for Payer: Aetna Better Health Medicaid/QHP	$46,333.19
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$46,333.19
Rate for Payer: Home State Health Plan Medicaid Managed Care	$46,333.19
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$46,333.19

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$99,977.85

Service Code	APR-DRG 6213
Min. Negotiated Rate	$99,977.85
Max. Negotiated Rate	$99,977.85
Rate for Payer: Aetna Better Health Medicaid/QHP	$99,977.85
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$99,977.85
Rate for Payer: Home State Health Plan Medicaid Managed Care	$99,977.85
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$99,977.85

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$13,283.86

Service Code	APR-DRG 6211
Min. Negotiated Rate	$13,283.86
Max. Negotiated Rate	$13,283.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$13,283.86
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13,283.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$13,283.86
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13,283.86

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$133,938.77

Service Code	APR-DRG 6214
Min. Negotiated Rate	$133,938.77
Max. Negotiated Rate	$133,938.77
Rate for Payer: Aetna Better Health Medicaid/QHP	$133,938.77
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$133,938.77
Rate for Payer: Home State Health Plan Medicaid Managed Care	$133,938.77
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$133,938.77

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$76,451.34

Service Code	APR-DRG 6254
Min. Negotiated Rate	$76,451.34
Max. Negotiated Rate	$76,451.34
Rate for Payer: Aetna Better Health Medicaid/QHP	$76,451.34
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$76,451.34
Rate for Payer: Home State Health Plan Medicaid Managed Care	$76,451.34
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$76,451.34

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$28,911.10

Service Code	APR-DRG 6251
Min. Negotiated Rate	$28,911.10
Max. Negotiated Rate	$28,911.10
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,911.10
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,911.10
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,911.10
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,911.10

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$42,135.23

Service Code	APR-DRG 6252
Min. Negotiated Rate	$42,135.23
Max. Negotiated Rate	$42,135.23
Rate for Payer: Aetna Better Health Medicaid/QHP	$42,135.23
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$42,135.23
Rate for Payer: Home State Health Plan Medicaid Managed Care	$42,135.23
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$42,135.23

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$53,844.26

Service Code	APR-DRG 6253
Min. Negotiated Rate	$53,844.26
Max. Negotiated Rate	$53,844.26
Rate for Payer: Aetna Better Health Medicaid/QHP	$53,844.26
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$53,844.26
Rate for Payer: Home State Health Plan Medicaid Managed Care	$53,844.26
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$53,844.26

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$47,757.14

Service Code	APR-DRG 6222
Min. Negotiated Rate	$47,757.14
Max. Negotiated Rate	$47,757.14
Rate for Payer: Aetna Better Health Medicaid/QHP	$47,757.14
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$47,757.14
Rate for Payer: Home State Health Plan Medicaid Managed Care	$47,757.14
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$47,757.14

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$86,271.21

Service Code	APR-DRG 6224
Min. Negotiated Rate	$86,271.21
Max. Negotiated Rate	$86,271.21
Rate for Payer: Aetna Better Health Medicaid/QHP	$86,271.21
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$86,271.21
Rate for Payer: Home State Health Plan Medicaid Managed Care	$86,271.21
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$86,271.21

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$86,271.21

Service Code	APR-DRG 6223
Min. Negotiated Rate	$86,271.21
Max. Negotiated Rate	$86,271.21
Rate for Payer: Aetna Better Health Medicaid/QHP	$86,271.21
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$86,271.21
Rate for Payer: Home State Health Plan Medicaid Managed Care	$86,271.21
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$86,271.21

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$35,413.15

Service Code	APR-DRG 6221
Min. Negotiated Rate	$35,413.15
Max. Negotiated Rate	$35,413.15
Rate for Payer: Aetna Better Health Medicaid/QHP	$35,413.15
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$35,413.15
Rate for Payer: Home State Health Plan Medicaid Managed Care	$35,413.15
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$35,413.15

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

Facility

$38,587.94

Service Code	APR-DRG 6404
Min. Negotiated Rate	$38,587.94
Max. Negotiated Rate	$38,587.94
Rate for Payer: Aetna Better Health Medicaid/QHP	$38,587.94
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$38,587.94
Rate for Payer: Home State Health Plan Medicaid Managed Care	$38,587.94
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$38,587.94

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

Facility

$3,258.10

Service Code	APR-DRG 6401
Min. Negotiated Rate	$3,258.10
Max. Negotiated Rate	$3,258.10
Rate for Payer: Aetna Better Health Medicaid/QHP	$3,258.10
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$3,258.10
Rate for Payer: Home State Health Plan Medicaid Managed Care	$3,258.10
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$3,258.10

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

Facility

$4,241.97

Service Code	APR-DRG 6402
Min. Negotiated Rate	$4,241.97
Max. Negotiated Rate	$4,241.97
Rate for Payer: Aetna Better Health Medicaid/QHP	$4,241.97
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$4,241.97
Rate for Payer: Home State Health Plan Medicaid Managed Care	$4,241.97
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$4,241.97

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

Facility

$8,260.76

Service Code	APR-DRG 6403
Min. Negotiated Rate	$8,260.76
Max. Negotiated Rate	$8,260.76
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,260.76
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,260.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,260.76
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,260.76

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$17,423.67

Service Code	APR-DRG 6361
Min. Negotiated Rate	$17,423.67
Max. Negotiated Rate	$17,423.67
Rate for Payer: Aetna Better Health Medicaid/QHP	$17,423.67
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$17,423.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17,423.67
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$17,423.67

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$26,619.58

Service Code	APR-DRG 6362
Min. Negotiated Rate	$26,619.58
Max. Negotiated Rate	$26,619.58
Rate for Payer: Aetna Better Health Medicaid/QHP	$26,619.58
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$26,619.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$26,619.58
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$26,619.58

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$51,581.04

Service Code	APR-DRG 6364
Min. Negotiated Rate	$51,581.04
Max. Negotiated Rate	$51,581.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$51,581.04
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$51,581.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$51,581.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$51,581.04

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$47,060.88

Service Code	APR-DRG 6363
Min. Negotiated Rate	$47,060.88
Max. Negotiated Rate	$47,060.88
Rate for Payer: Aetna Better Health Medicaid/QHP	$47,060.88
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$47,060.88
Rate for Payer: Home State Health Plan Medicaid Managed Care	$47,060.88
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$47,060.88

Know your out-of-pocket cost for care.

All Charges