Madison Medical Center

All Charges

Charge

Type

Setting

Price

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC

Facility

$36,341.62

Service Code	MSDRG 314
Min. Negotiated Rate	$18,170.81
Max. Negotiated Rate	$36,341.62
Rate for Payer: Aetna Medicare Advantage	$18,170.81
Rate for Payer: Cigna Commercial HMO & PPO	$18,170.81
Rate for Payer: Home State Health Plan Medicare Advantage	$18,170.81
Rate for Payer: Humana Commercial	$36,341.62
Rate for Payer: Humana Medicare Advantage	$18,170.81

OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$14,322.80

Service Code	MSDRG 316
Min. Negotiated Rate	$7,161.40
Max. Negotiated Rate	$14,322.80
Rate for Payer: Aetna Medicare Advantage	$7,161.40
Rate for Payer: Cigna Commercial HMO & PPO	$7,161.40
Rate for Payer: Home State Health Plan Medicare Advantage	$7,161.40
Rate for Payer: Humana Commercial	$14,322.80
Rate for Payer: Humana Medicare Advantage	$7,161.40

OTHER CIRCULATORY SYSTEM O.R. PROCEDURES

Facility

$56,177.06

Service Code	MSDRG 264
Min. Negotiated Rate	$28,088.53
Max. Negotiated Rate	$56,177.06
Rate for Payer: Aetna Medicare Advantage	$28,088.53
Rate for Payer: Cigna Commercial HMO & PPO	$28,088.53
Rate for Payer: Home State Health Plan Medicare Advantage	$28,088.53
Rate for Payer: Humana Commercial	$56,177.06
Rate for Payer: Humana Medicare Advantage	$28,088.53

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$14,727.59

Service Code	APR-DRG 1801
Min. Negotiated Rate	$14,727.59
Max. Negotiated Rate	$14,727.59
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,727.59
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,727.59
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,727.59
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,727.59

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$54,931.22

Service Code	APR-DRG 1804
Min. Negotiated Rate	$54,931.22
Max. Negotiated Rate	$54,931.22
Rate for Payer: Aetna Better Health Medicaid/QHP	$54,931.22
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$54,931.22
Rate for Payer: Home State Health Plan Medicaid Managed Care	$54,931.22
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$54,931.22

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$18,947.09

Service Code	APR-DRG 1802
Min. Negotiated Rate	$18,947.09
Max. Negotiated Rate	$18,947.09
Rate for Payer: Aetna Better Health Medicaid/QHP	$18,947.09
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$18,947.09
Rate for Payer: Home State Health Plan Medicaid Managed Care	$18,947.09
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$18,947.09

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$23,799.89

Service Code	APR-DRG 1803
Min. Negotiated Rate	$23,799.89
Max. Negotiated Rate	$23,799.89
Rate for Payer: Aetna Better Health Medicaid/QHP	$23,799.89
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$23,799.89
Rate for Payer: Home State Health Plan Medicaid Managed Care	$23,799.89
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$23,799.89

OTHER COMPLICATIONS OF TREATMENT

Facility

$20,190.58

Service Code	APR-DRG 8133
Min. Negotiated Rate	$20,190.58
Max. Negotiated Rate	$20,190.58
Rate for Payer: Aetna Better Health Medicaid/QHP	$20,190.58
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$20,190.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$20,190.58
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$20,190.58

OTHER COMPLICATIONS OF TREATMENT

Facility

$27,146.04

Service Code	APR-DRG 8134
Min. Negotiated Rate	$27,146.04
Max. Negotiated Rate	$27,146.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$27,146.04
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$27,146.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$27,146.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$27,146.04

OTHER COMPLICATIONS OF TREATMENT

Facility

$6,737.46

Service Code	APR-DRG 8131
Min. Negotiated Rate	$6,737.46
Max. Negotiated Rate	$6,737.46
Rate for Payer: Aetna Better Health Medicaid/QHP	$6,737.46
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6,737.46
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6,737.46
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$6,737.46

OTHER COMPLICATIONS OF TREATMENT

Facility

$8,630.44

Service Code	APR-DRG 8132
Min. Negotiated Rate	$8,630.44
Max. Negotiated Rate	$8,630.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,630.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,630.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,630.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,630.44

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$13,101.36

Service Code	APR-DRG 2291
Min. Negotiated Rate	$13,101.36
Max. Negotiated Rate	$13,101.36
Rate for Payer: Aetna Better Health Medicaid/QHP	$13,101.36
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13,101.36
Rate for Payer: Home State Health Plan Medicaid Managed Care	$13,101.36
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13,101.36

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$48,832.17

Service Code	APR-DRG 2294
Min. Negotiated Rate	$48,832.17
Max. Negotiated Rate	$48,832.17
Rate for Payer: Aetna Better Health Medicaid/QHP	$48,832.17
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$48,832.17
Rate for Payer: Home State Health Plan Medicaid Managed Care	$48,832.17
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$48,832.17

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$18,723.36

Service Code	APR-DRG 2292
Min. Negotiated Rate	$18,723.36
Max. Negotiated Rate	$18,723.36
Rate for Payer: Aetna Better Health Medicaid/QHP	$18,723.36
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$18,723.36
Rate for Payer: Home State Health Plan Medicaid Managed Care	$18,723.36
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$18,723.36

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$30,963.07

Service Code	APR-DRG 2293
Min. Negotiated Rate	$30,963.07
Max. Negotiated Rate	$30,963.07
Rate for Payer: Aetna Better Health Medicaid/QHP	$30,963.07
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$30,963.07
Rate for Payer: Home State Health Plan Medicaid Managed Care	$30,963.07
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$30,963.07

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$26,168.67

Service Code	APR-DRG 2544
Min. Negotiated Rate	$26,168.67
Max. Negotiated Rate	$26,168.67
Rate for Payer: Aetna Better Health Medicaid/QHP	$26,168.67
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$26,168.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$26,168.67
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$26,168.67

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$17,654.49

Service Code	APR-DRG 2543
Min. Negotiated Rate	$17,654.49
Max. Negotiated Rate	$17,654.49
Rate for Payer: Aetna Better Health Medicaid/QHP	$17,654.49
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$17,654.49
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17,654.49
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$17,654.49

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$7,510.15

Service Code	APR-DRG 2541
Min. Negotiated Rate	$7,510.15
Max. Negotiated Rate	$7,510.15
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,510.15
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,510.15
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,510.15
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,510.15

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$9,768.89

Service Code	APR-DRG 2542
Min. Negotiated Rate	$9,768.89
Max. Negotiated Rate	$9,768.89
Rate for Payer: Aetna Better Health Medicaid/QHP	$9,768.89
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9,768.89
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9,768.89
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9,768.89

OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC

Facility

$18,287.64

Service Code	MSDRG 394
Min. Negotiated Rate	$9,143.82
Max. Negotiated Rate	$18,287.64
Rate for Payer: Aetna Medicare Advantage	$9,143.82
Rate for Payer: Cigna Commercial HMO & PPO	$9,143.82
Rate for Payer: Home State Health Plan Medicare Advantage	$9,143.82
Rate for Payer: Humana Commercial	$18,287.64
Rate for Payer: Humana Medicare Advantage	$9,143.82

OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC

Facility

$28,686.88

Service Code	MSDRG 393
Min. Negotiated Rate	$14,343.44
Max. Negotiated Rate	$28,686.88
Rate for Payer: Aetna Medicare Advantage	$14,343.44
Rate for Payer: Cigna Commercial HMO & PPO	$14,343.44
Rate for Payer: Home State Health Plan Medicare Advantage	$14,343.44
Rate for Payer: Humana Commercial	$28,686.88
Rate for Payer: Humana Medicare Advantage	$14,343.44

OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$13,807.16

Service Code	MSDRG 395
Min. Negotiated Rate	$6,903.58
Max. Negotiated Rate	$13,807.16
Rate for Payer: Aetna Medicare Advantage	$6,903.58
Rate for Payer: Cigna Commercial HMO & PPO	$6,903.58
Rate for Payer: Home State Health Plan Medicare Advantage	$6,903.58
Rate for Payer: Humana Commercial	$13,807.16
Rate for Payer: Humana Medicare Advantage	$6,903.58

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC

Facility

$40,127.26

Service Code	MSDRG 357
Min. Negotiated Rate	$20,063.63
Max. Negotiated Rate	$40,127.26
Rate for Payer: Aetna Medicare Advantage	$20,063.63
Rate for Payer: Cigna Commercial HMO & PPO	$20,063.63
Rate for Payer: Home State Health Plan Medicare Advantage	$20,063.63
Rate for Payer: Humana Commercial	$40,127.26
Rate for Payer: Humana Medicare Advantage	$20,063.63

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC

Facility

$72,868.64

Service Code	MSDRG 356
Min. Negotiated Rate	$36,434.32
Max. Negotiated Rate	$72,868.64
Rate for Payer: Aetna Medicare Advantage	$36,434.32
Rate for Payer: Cigna Commercial HMO & PPO	$36,434.32
Rate for Payer: Home State Health Plan Medicare Advantage	$36,434.32
Rate for Payer: Humana Commercial	$72,868.64
Rate for Payer: Humana Medicare Advantage	$36,434.32

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$25,522.58

Service Code	MSDRG 358
Min. Negotiated Rate	$12,761.29
Max. Negotiated Rate	$25,522.58
Rate for Payer: Aetna Medicare Advantage	$12,761.29
Rate for Payer: Cigna Commercial HMO & PPO	$12,761.29
Rate for Payer: Home State Health Plan Medicare Advantage	$12,761.29
Rate for Payer: Humana Commercial	$25,522.58
Rate for Payer: Humana Medicare Advantage	$12,761.29

Know your out-of-pocket cost for care.

All Charges