Madison Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$13,835.43

Service Code	APR-DRG 1153
Min. Negotiated Rate	$13,835.43
Max. Negotiated Rate	$13,835.43
Rate for Payer: Aetna Better Health Medicaid/QHP	$13,835.43
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13,835.43
Rate for Payer: Home State Health Plan Medicaid Managed Care	$13,835.43
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13,835.43

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

Facility

$7,174.27

Service Code	APR-DRG 1151
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

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$49,518.16

Service Code	APR-DRG 0984
Min. Negotiated Rate	$49,518.16
Max. Negotiated Rate	$49,518.16
Rate for Payer: Aetna Better Health Medicaid/QHP	$49,518.16
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$49,518.16
Rate for Payer: Home State Health Plan Medicaid Managed Care	$49,518.16
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$49,518.16

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$24,847.37

Service Code	APR-DRG 0983
Min. Negotiated Rate	$24,847.37
Max. Negotiated Rate	$24,847.37
Rate for Payer: Aetna Better Health Medicaid/QHP	$24,847.37
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$24,847.37
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24,847.37
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$24,847.37

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$16,517.46

Service Code	APR-DRG 0982
Min. Negotiated Rate	$16,517.46
Max. Negotiated Rate	$16,517.46
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,517.46
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,517.46
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,517.46
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,517.46

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$6,705.54

Service Code	APR-DRG 0981
Min. Negotiated Rate	$6,705.54
Max. Negotiated Rate	$6,705.54
Rate for Payer: Aetna Better Health Medicaid/QHP	$6,705.54
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6,705.54
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6,705.54
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$6,705.54

OTHER ENDOCRINE DISORDERS

Facility

$10,883.12

Service Code	APR-DRG 4242
Min. Negotiated Rate	$10,883.12
Max. Negotiated Rate	$10,883.12
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,883.12
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,883.12
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,883.12
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,883.12

OTHER ENDOCRINE DISORDERS

Facility

$28,440.73

Service Code	APR-DRG 4244
Min. Negotiated Rate	$28,440.73
Max. Negotiated Rate	$28,440.73
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,440.73
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,440.73
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,440.73
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,440.73

OTHER ENDOCRINE DISORDERS

Facility

$15,981.94

Service Code	APR-DRG 4243
Min. Negotiated Rate	$15,981.94
Max. Negotiated Rate	$15,981.94
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,981.94
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,981.94
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,981.94
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,981.94

OTHER ENDOCRINE DISORDERS

Facility

$8,149.63

Service Code	APR-DRG 4241
Min. Negotiated Rate	$8,149.63
Max. Negotiated Rate	$8,149.63
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,149.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,149.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,149.63
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,149.63

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC

Facility

$37,816.18

Service Code	MSDRG 629
Min. Negotiated Rate	$18,908.09
Max. Negotiated Rate	$37,816.18
Rate for Payer: Aetna Medicare Advantage	$18,908.09
Rate for Payer: Cigna Commercial HMO & PPO	$18,908.09
Rate for Payer: Home State Health Plan Medicare Advantage	$18,908.09
Rate for Payer: Humana Commercial	$37,816.18
Rate for Payer: Humana Medicare Advantage	$18,908.09

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC

Facility

$62,302.40

Service Code	MSDRG 628
Min. Negotiated Rate	$31,151.20
Max. Negotiated Rate	$62,302.40
Rate for Payer: Aetna Medicare Advantage	$31,151.20
Rate for Payer: Cigna Commercial HMO & PPO	$31,151.20
Rate for Payer: Home State Health Plan Medicare Advantage	$31,151.20
Rate for Payer: Humana Commercial	$62,302.40
Rate for Payer: Humana Medicare Advantage	$31,151.20

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC

Facility

$26,488.90

Service Code	MSDRG 630
Min. Negotiated Rate	$13,244.45
Max. Negotiated Rate	$26,488.90
Rate for Payer: Aetna Medicare Advantage	$13,244.45
Rate for Payer: Cigna Commercial HMO & PPO	$13,244.45
Rate for Payer: Home State Health Plan Medicare Advantage	$13,244.45
Rate for Payer: Humana Commercial	$26,488.90
Rate for Payer: Humana Medicare Advantage	$13,244.45

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC

Facility

$73,981.44

Service Code	MSDRG 319
Min. Negotiated Rate	$36,990.72
Max. Negotiated Rate	$73,981.44
Rate for Payer: Aetna Medicare Advantage	$36,990.72
Rate for Payer: Cigna Commercial HMO & PPO	$36,990.72
Rate for Payer: Home State Health Plan Medicare Advantage	$36,990.72
Rate for Payer: Humana Commercial	$73,981.44
Rate for Payer: Humana Medicare Advantage	$36,990.72

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility

$41,384.42

Service Code	MSDRG 320
Min. Negotiated Rate	$20,692.21
Max. Negotiated Rate	$41,384.42
Rate for Payer: Aetna Medicare Advantage	$20,692.21
Rate for Payer: Cigna Commercial HMO & PPO	$20,692.21
Rate for Payer: Home State Health Plan Medicare Advantage	$20,692.21
Rate for Payer: Humana Commercial	$41,384.42
Rate for Payer: Humana Medicare Advantage	$20,692.21

OTHER ESOPHAGEAL DISORDERS

Facility

$8,552.93

Service Code	APR-DRG 2432
Min. Negotiated Rate	$8,552.93
Max. Negotiated Rate	$8,552.93
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,552.93
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,552.93
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,552.93
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,552.93

OTHER ESOPHAGEAL DISORDERS

Facility

$23,547.80

Service Code	APR-DRG 2434
Min. Negotiated Rate	$23,547.80
Max. Negotiated Rate	$23,547.80
Rate for Payer: Aetna Better Health Medicaid/QHP	$23,547.80
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$23,547.80
Rate for Payer: Home State Health Plan Medicaid Managed Care	$23,547.80
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$23,547.80

OTHER ESOPHAGEAL DISORDERS

Facility

$7,079.00

Service Code	APR-DRG 2431
Min. Negotiated Rate	$7,079.00
Max. Negotiated Rate	$7,079.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,079.00
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,079.00
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,079.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,079.00

OTHER ESOPHAGEAL DISORDERS

Facility

$13,587.55

Service Code	APR-DRG 2433
Min. Negotiated Rate	$13,587.55
Max. Negotiated Rate	$13,587.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$13,587.55
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13,587.55
Rate for Payer: Home State Health Plan Medicaid Managed Care	$13,587.55
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13,587.55

OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$12,366.66

Service Code	MSDRG 951
Min. Negotiated Rate	$6,183.33
Max. Negotiated Rate	$12,366.66
Rate for Payer: Aetna Medicare Advantage	$6,183.33
Rate for Payer: Cigna Commercial HMO & PPO	$6,183.33
Rate for Payer: Home State Health Plan Medicare Advantage	$6,183.33
Rate for Payer: Humana Commercial	$12,366.66
Rate for Payer: Humana Medicare Advantage	$6,183.33

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$5,507.36

Service Code	APR-DRG 5181
Min. Negotiated Rate	$5,507.36
Max. Negotiated Rate	$5,507.36
Rate for Payer: Aetna Better Health Medicaid/QHP	$5,507.36
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5,507.36
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5,507.36
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5,507.36

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$42,685.97

Service Code	APR-DRG 5184
Min. Negotiated Rate	$42,685.97
Max. Negotiated Rate	$42,685.97
Rate for Payer: Aetna Better Health Medicaid/QHP	$42,685.97
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$42,685.97
Rate for Payer: Home State Health Plan Medicaid Managed Care	$42,685.97
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$42,685.97

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$16,089.40

Service Code	APR-DRG 5182
Min. Negotiated Rate	$16,089.40
Max. Negotiated Rate	$16,089.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,089.40
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,089.40
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,089.40
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,089.40

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$24,721.64

Service Code	APR-DRG 5183
Min. Negotiated Rate	$24,721.64
Max. Negotiated Rate	$24,721.64
Rate for Payer: Aetna Better Health Medicaid/QHP	$24,721.64
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$24,721.64
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24,721.64
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$24,721.64

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC

Facility

$43,946.68

Service Code	MSDRG 749
Min. Negotiated Rate	$21,973.34
Max. Negotiated Rate	$43,946.68
Rate for Payer: Aetna Medicare Advantage	$21,973.34
Rate for Payer: Cigna Commercial HMO & PPO	$21,973.34
Rate for Payer: Home State Health Plan Medicare Advantage	$21,973.34
Rate for Payer: Humana Commercial	$43,946.68
Rate for Payer: Humana Medicare Advantage	$21,973.34

Know your out-of-pocket cost for care.

All Charges