Madison Medical Center

All Charges

Charge

Type

Setting

Price

OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES

Facility

$13,207.68

Service Code	APR-DRG 3473
Min. Negotiated Rate	$13,207.68
Max. Negotiated Rate	$13,207.68
Rate for Payer: Aetna Better Health Medicaid/QHP	$13,207.68
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13,207.68
Rate for Payer: Home State Health Plan Medicaid Managed Care	$13,207.68
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13,207.68

OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES

Facility

$10,415.63

Service Code	APR-DRG 3472
Min. Negotiated Rate	$10,415.63
Max. Negotiated Rate	$10,415.63
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,415.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,415.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,415.63
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,415.63

OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES

Facility

$8,567.52

Service Code	APR-DRG 3471
Min. Negotiated Rate	$8,567.52
Max. Negotiated Rate	$8,567.52
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,567.52
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,567.52
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,567.52
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,567.52

OTHER BLADDER PROCEDURES

Facility

$12,353.42

Service Code	APR-DRG 4451
Min. Negotiated Rate	$12,353.42
Max. Negotiated Rate	$12,353.42
Rate for Payer: Aetna Better Health Medicaid/QHP	$12,353.42
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$12,353.42
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12,353.42
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$12,353.42

OTHER BLADDER PROCEDURES

Facility

$16,715.30

Service Code	APR-DRG 4452
Min. Negotiated Rate	$16,715.30
Max. Negotiated Rate	$16,715.30
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,715.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,715.30
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,715.30
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,715.30

OTHER BLADDER PROCEDURES

Facility

$18,894.39

Service Code	APR-DRG 4453
Min. Negotiated Rate	$18,894.39
Max. Negotiated Rate	$18,894.39
Rate for Payer: Aetna Better Health Medicaid/QHP	$18,894.39
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$18,894.39
Rate for Payer: Home State Health Plan Medicaid Managed Care	$18,894.39
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$18,894.39

OTHER BLADDER PROCEDURES

Facility

$33,322.44

Service Code	APR-DRG 4454
Min. Negotiated Rate	$33,322.44
Max. Negotiated Rate	$33,322.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$33,322.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$33,322.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$33,322.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$33,322.44

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$75,180.04

Service Code	APR-DRG 1674
Min. Negotiated Rate	$75,180.04
Max. Negotiated Rate	$75,180.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$75,180.04
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$75,180.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$75,180.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$75,180.04

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$52,970.32

Service Code	APR-DRG 1673
Min. Negotiated Rate	$52,970.32
Max. Negotiated Rate	$52,970.32
Rate for Payer: Aetna Better Health Medicaid/QHP	$52,970.32
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$52,970.32
Rate for Payer: Home State Health Plan Medicaid Managed Care	$52,970.32
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$52,970.32

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$22,895.71

Service Code	APR-DRG 1672
Min. Negotiated Rate	$22,895.71
Max. Negotiated Rate	$22,895.71
Rate for Payer: Aetna Better Health Medicaid/QHP	$22,895.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22,895.71
Rate for Payer: Home State Health Plan Medicaid Managed Care	$22,895.71
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22,895.71

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$22,895.71

Service Code	APR-DRG 1671
Min. Negotiated Rate	$22,895.71
Max. Negotiated Rate	$22,895.71
Rate for Payer: Aetna Better Health Medicaid/QHP	$22,895.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22,895.71
Rate for Payer: Home State Health Plan Medicaid Managed Care	$22,895.71
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22,895.71

OTHER CARDIOTHORACIC PROCEDURES WITH MCC

Facility

$81,672.72

Service Code	MSDRG 228
Min. Negotiated Rate	$40,836.36
Max. Negotiated Rate	$81,672.72
Rate for Payer: Aetna Medicare Advantage	$40,836.36
Rate for Payer: Cigna Commercial HMO & PPO	$40,836.36
Rate for Payer: Home State Health Plan Medicare Advantage	$40,836.36
Rate for Payer: Humana Commercial	$81,672.72
Rate for Payer: Humana Medicare Advantage	$40,836.36

OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC

Facility

$53,152.40

Service Code	MSDRG 229
Min. Negotiated Rate	$26,576.20
Max. Negotiated Rate	$53,152.40
Rate for Payer: Aetna Medicare Advantage	$26,576.20
Rate for Payer: Cigna Commercial HMO & PPO	$26,576.20
Rate for Payer: Home State Health Plan Medicare Advantage	$26,576.20
Rate for Payer: Humana Commercial	$53,152.40
Rate for Payer: Humana Medicare Advantage	$26,576.20

OTHER CEREBROVASCULAR DISORDERS WITH CC

Facility

$19,700.78

Service Code	MSDRG 071
Min. Negotiated Rate	$9,850.39
Max. Negotiated Rate	$19,700.78
Rate for Payer: Aetna Medicare Advantage	$9,850.39
Rate for Payer: Cigna Commercial HMO & PPO	$9,850.39
Rate for Payer: Home State Health Plan Medicare Advantage	$9,850.39
Rate for Payer: Humana Commercial	$19,700.78
Rate for Payer: Humana Medicare Advantage	$9,850.39

OTHER CEREBROVASCULAR DISORDERS WITH MCC

Facility

$29,718.76

Service Code	MSDRG 070
Min. Negotiated Rate	$14,859.38
Max. Negotiated Rate	$29,718.76
Rate for Payer: Aetna Medicare Advantage	$14,859.38
Rate for Payer: Cigna Commercial HMO & PPO	$14,859.38
Rate for Payer: Home State Health Plan Medicare Advantage	$14,859.38
Rate for Payer: Humana Commercial	$29,718.76
Rate for Payer: Humana Medicare Advantage	$14,859.38

OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility

$15,478.60

Service Code	MSDRG 072
Min. Negotiated Rate	$7,739.30
Max. Negotiated Rate	$15,478.60
Rate for Payer: Aetna Medicare Advantage	$7,739.30
Rate for Payer: Cigna Commercial HMO & PPO	$7,739.30
Rate for Payer: Home State Health Plan Medicare Advantage	$7,739.30
Rate for Payer: Humana Commercial	$15,478.60
Rate for Payer: Humana Medicare Advantage	$7,739.30

OTHER CHEMOTHERAPY

Facility

$7,889.85

Service Code	APR-DRG 6961
Min. Negotiated Rate	$7,889.85
Max. Negotiated Rate	$7,889.85
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,889.85
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,889.85
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,889.85
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,889.85

OTHER CHEMOTHERAPY

Facility

$37,058.42

Service Code	APR-DRG 6964
Min. Negotiated Rate	$37,058.42
Max. Negotiated Rate	$37,058.42
Rate for Payer: Aetna Better Health Medicaid/QHP	$37,058.42
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$37,058.42
Rate for Payer: Home State Health Plan Medicaid Managed Care	$37,058.42
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$37,058.42

OTHER CHEMOTHERAPY

Facility

$14,991.08

Service Code	APR-DRG 6963
Min. Negotiated Rate	$14,991.08
Max. Negotiated Rate	$14,991.08
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,991.08
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,991.08
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,991.08
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,991.08

OTHER CHEMOTHERAPY

Facility

$9,987.58

Service Code	APR-DRG 6962
Min. Negotiated Rate	$9,987.58
Max. Negotiated Rate	$9,987.58
Rate for Payer: Aetna Better Health Medicaid/QHP	$9,987.58
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9,987.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9,987.58
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9,987.58

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$12,322.91

Service Code	APR-DRG 2073
Min. Negotiated Rate	$12,322.91
Max. Negotiated Rate	$12,322.91
Rate for Payer: Aetna Better Health Medicaid/QHP	$12,322.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$12,322.91
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12,322.91
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$12,322.91

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$4,231.52

Service Code	APR-DRG 2071
Min. Negotiated Rate	$4,231.52
Max. Negotiated Rate	$4,231.52
Rate for Payer: Aetna Better Health Medicaid/QHP	$4,231.52
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$4,231.52
Rate for Payer: Home State Health Plan Medicaid Managed Care	$4,231.52
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$4,231.52

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$6,370.86

Service Code	APR-DRG 2072
Min. Negotiated Rate	$6,370.86
Max. Negotiated Rate	$6,370.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$6,370.86
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6,370.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6,370.86
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$6,370.86

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$21,358.24

Service Code	APR-DRG 2074
Min. Negotiated Rate	$21,358.24
Max. Negotiated Rate	$21,358.24
Rate for Payer: Aetna Better Health Medicaid/QHP	$21,358.24
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$21,358.24
Rate for Payer: Home State Health Plan Medicaid Managed Care	$21,358.24
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$21,358.24

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC

Facility

$18,719.56

Service Code	MSDRG 315
Min. Negotiated Rate	$9,359.78
Max. Negotiated Rate	$18,719.56
Rate for Payer: Aetna Medicare Advantage	$9,359.78
Rate for Payer: Cigna Commercial HMO & PPO	$9,359.78
Rate for Payer: Home State Health Plan Medicare Advantage	$9,359.78
Rate for Payer: Humana Commercial	$18,719.56
Rate for Payer: Humana Medicare Advantage	$9,359.78

Know your out-of-pocket cost for care.

All Charges