Madison Medical Center

All Charges

Charge

Type

Setting

Price

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$5,818.00

Service Code	APR-DRG 0581
Min. Negotiated Rate	$5,818.00
Max. Negotiated Rate	$5,818.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$5,818.00
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5,818.00
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5,818.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5,818.00

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$20,068.53

Service Code	APR-DRG 0583
Min. Negotiated Rate	$20,068.53
Max. Negotiated Rate	$20,068.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$20,068.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$20,068.53
Rate for Payer: Home State Health Plan Medicaid Managed Care	$20,068.53
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$20,068.53

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$22,046.08

Service Code	APR-DRG 0584
Min. Negotiated Rate	$22,046.08
Max. Negotiated Rate	$22,046.08
Rate for Payer: Aetna Better Health Medicaid/QHP	$22,046.08
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22,046.08
Rate for Payer: Home State Health Plan Medicaid Managed Care	$22,046.08
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22,046.08

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$9,254.44

Service Code	APR-DRG 0582
Min. Negotiated Rate	$9,254.44
Max. Negotiated Rate	$9,254.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$9,254.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9,254.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9,254.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9,254.44

OTHER DISORDERS OF NERVOUS SYSTEM WITH CC

Facility

$19,653.80

Service Code	MSDRG 092
Min. Negotiated Rate	$9,826.90
Max. Negotiated Rate	$19,653.80
Rate for Payer: Aetna Medicare Advantage	$9,826.90
Rate for Payer: Cigna Commercial HMO & PPO	$9,826.90
Rate for Payer: Home State Health Plan Medicare Advantage	$9,826.90
Rate for Payer: Humana Commercial	$19,653.80
Rate for Payer: Humana Medicare Advantage	$9,826.90

OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC

Facility

$31,158.66

Service Code	MSDRG 091
Min. Negotiated Rate	$15,579.33
Max. Negotiated Rate	$31,158.66
Rate for Payer: Aetna Medicare Advantage	$15,579.33
Rate for Payer: Cigna Commercial HMO & PPO	$15,579.33
Rate for Payer: Home State Health Plan Medicare Advantage	$15,579.33
Rate for Payer: Humana Commercial	$31,158.66
Rate for Payer: Humana Medicare Advantage	$15,579.33

OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC

Facility

$16,106.12

Service Code	MSDRG 093
Min. Negotiated Rate	$8,053.06
Max. Negotiated Rate	$16,106.12
Rate for Payer: Aetna Medicare Advantage	$8,053.06
Rate for Payer: Cigna Commercial HMO & PPO	$8,053.06
Rate for Payer: Home State Health Plan Medicare Advantage	$8,053.06
Rate for Payer: Humana Commercial	$16,106.12
Rate for Payer: Humana Medicare Advantage	$8,053.06

OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT

Facility

$24,350.16

Service Code	MSDRG 124
Min. Negotiated Rate	$12,175.08
Max. Negotiated Rate	$24,350.16
Rate for Payer: Aetna Medicare Advantage	$12,175.08
Rate for Payer: Cigna Commercial HMO & PPO	$12,175.08
Rate for Payer: Home State Health Plan Medicare Advantage	$12,175.08
Rate for Payer: Humana Commercial	$24,350.16
Rate for Payer: Humana Medicare Advantage	$12,175.08

OTHER DISORDERS OF THE EYE WITHOUT MCC

Facility

$15,660.12

Service Code	MSDRG 125
Min. Negotiated Rate	$7,830.06
Max. Negotiated Rate	$15,660.12
Rate for Payer: Aetna Medicare Advantage	$7,830.06
Rate for Payer: Cigna Commercial HMO & PPO	$7,830.06
Rate for Payer: Home State Health Plan Medicare Advantage	$7,830.06
Rate for Payer: Humana Commercial	$15,660.12
Rate for Payer: Humana Medicare Advantage	$7,830.06

OTHER DISORDERS OF THE LIVER

Facility

$14,706.63

Service Code	APR-DRG 2833
Min. Negotiated Rate	$14,706.63
Max. Negotiated Rate	$14,706.63
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,706.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,706.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,706.63
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,706.63

OTHER DISORDERS OF THE LIVER

Facility

$8,397.91

Service Code	APR-DRG 2831
Min. Negotiated Rate	$8,397.91
Max. Negotiated Rate	$8,397.91
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,397.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,397.91
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,397.91
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,397.91

OTHER DISORDERS OF THE LIVER

Facility

$8,397.91

Service Code	APR-DRG 2832
Min. Negotiated Rate	$8,397.91
Max. Negotiated Rate	$8,397.91
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,397.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,397.91
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,397.91
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,397.91

OTHER DISORDERS OF THE LIVER

Facility

$37,442.98

Service Code	APR-DRG 2834
Min. Negotiated Rate	$37,442.98
Max. Negotiated Rate	$37,442.98
Rate for Payer: Aetna Better Health Medicaid/QHP	$37,442.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$37,442.98
Rate for Payer: Home State Health Plan Medicaid Managed Care	$37,442.98
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$37,442.98

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$33,243.63

Service Code	APR-DRG 7764
Min. Negotiated Rate	$33,243.63
Max. Negotiated Rate	$33,243.63
Rate for Payer: Aetna Better Health Medicaid/QHP	$33,243.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$33,243.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$33,243.63
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$33,243.63

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$12,974.03

Service Code	APR-DRG 7763
Min. Negotiated Rate	$12,974.03
Max. Negotiated Rate	$12,974.03
Rate for Payer: Aetna Better Health Medicaid/QHP	$12,974.03
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$12,974.03
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12,974.03
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$12,974.03

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$9,029.81

Service Code	APR-DRG 7761
Min. Negotiated Rate	$9,029.81
Max. Negotiated Rate	$9,029.81
Rate for Payer: Aetna Better Health Medicaid/QHP	$9,029.81
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9,029.81
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9,029.81
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9,029.81

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$10,538.63

Service Code	APR-DRG 7762
Min. Negotiated Rate	$10,538.63
Max. Negotiated Rate	$10,538.63
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,538.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,538.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,538.63
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,538.63

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC

Facility

$17,987.18

Service Code	MSDRG 155
Min. Negotiated Rate	$8,993.59
Max. Negotiated Rate	$17,987.18
Rate for Payer: Aetna Medicare Advantage	$8,993.59
Rate for Payer: Cigna Commercial HMO & PPO	$8,993.59
Rate for Payer: Home State Health Plan Medicare Advantage	$8,993.59
Rate for Payer: Humana Commercial	$17,987.18
Rate for Payer: Humana Medicare Advantage	$8,993.59

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC

Facility

$28,122.88

Service Code	MSDRG 154
Min. Negotiated Rate	$14,061.44
Max. Negotiated Rate	$28,122.88
Rate for Payer: Aetna Medicare Advantage	$14,061.44
Rate for Payer: Cigna Commercial HMO & PPO	$14,061.44
Rate for Payer: Home State Health Plan Medicare Advantage	$14,061.44
Rate for Payer: Humana Commercial	$28,122.88
Rate for Payer: Humana Medicare Advantage	$14,061.44

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC

Facility

$14,463.02

Service Code	MSDRG 156
Min. Negotiated Rate	$7,231.51
Max. Negotiated Rate	$14,463.02
Rate for Payer: Aetna Medicare Advantage	$7,231.51
Rate for Payer: Cigna Commercial HMO & PPO	$7,231.51
Rate for Payer: Home State Health Plan Medicare Advantage	$7,231.51
Rate for Payer: Humana Commercial	$14,463.02
Rate for Payer: Humana Medicare Advantage	$7,231.51

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC

Facility

$30,791.58

Service Code	MSDRG 144
Min. Negotiated Rate	$15,395.79
Max. Negotiated Rate	$30,791.58
Rate for Payer: Aetna Medicare Advantage	$15,395.79
Rate for Payer: Cigna Commercial HMO & PPO	$15,395.79
Rate for Payer: Home State Health Plan Medicare Advantage	$15,395.79
Rate for Payer: Humana Commercial	$30,791.58
Rate for Payer: Humana Medicare Advantage	$15,395.79

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC

Facility

$62,616.44

Service Code	MSDRG 143
Min. Negotiated Rate	$31,308.22
Max. Negotiated Rate	$62,616.44
Rate for Payer: Aetna Medicare Advantage	$31,308.22
Rate for Payer: Cigna Commercial HMO & PPO	$31,308.22
Rate for Payer: Home State Health Plan Medicare Advantage	$31,308.22
Rate for Payer: Humana Commercial	$62,616.44
Rate for Payer: Humana Medicare Advantage	$31,308.22

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$22,459.74

Service Code	MSDRG 145
Min. Negotiated Rate	$11,229.87
Max. Negotiated Rate	$22,459.74
Rate for Payer: Aetna Medicare Advantage	$11,229.87
Rate for Payer: Cigna Commercial HMO & PPO	$11,229.87
Rate for Payer: Home State Health Plan Medicare Advantage	$11,229.87
Rate for Payer: Humana Commercial	$22,459.74
Rate for Payer: Humana Medicare Advantage	$11,229.87

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$20,480.87

Service Code	APR-DRG 1154
Min. Negotiated Rate	$20,480.87
Max. Negotiated Rate	$20,480.87
Rate for Payer: Aetna Better Health Medicaid/QHP	$20,480.87
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$20,480.87
Rate for Payer: Home State Health Plan Medicaid Managed Care	$20,480.87
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$20,480.87

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$7,174.27

Service Code	APR-DRG 1152
Min. Negotiated Rate	$7,174.27
Max. Negotiated Rate	$7,174.27
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,174.27
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,174.27
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,174.27
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,174.27

Know your out-of-pocket cost for care.

All Charges