Madison Medical Center

All Charges

Charge

Type

Setting

Price

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$7,959.48

Service Code	APR-DRG 3511
Min. Negotiated Rate	$7,959.48
Max. Negotiated Rate	$7,959.48
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,959.48
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,959.48
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,959.48
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,959.48

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$14,259.73

Service Code	APR-DRG 3513
Min. Negotiated Rate	$14,259.73
Max. Negotiated Rate	$14,259.73
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,259.73
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,259.73
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,259.73
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,259.73

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC

Facility

$18,893.26

Service Code	MSDRG 565
Min. Negotiated Rate	$9,446.63
Max. Negotiated Rate	$18,893.26
Rate for Payer: Aetna Medicare Advantage	$9,446.63
Rate for Payer: Cigna Commercial HMO & PPO	$9,446.63
Rate for Payer: Home State Health Plan Medicare Advantage	$9,446.63
Rate for Payer: Humana Commercial	$18,893.26
Rate for Payer: Humana Medicare Advantage	$9,446.63

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC

Facility

$27,809.40

Service Code	MSDRG 564
Min. Negotiated Rate	$13,904.70
Max. Negotiated Rate	$27,809.40
Rate for Payer: Aetna Medicare Advantage	$13,904.70
Rate for Payer: Cigna Commercial HMO & PPO	$13,904.70
Rate for Payer: Home State Health Plan Medicare Advantage	$13,904.70
Rate for Payer: Humana Commercial	$27,809.40
Rate for Payer: Humana Medicare Advantage	$13,904.70

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

Facility

$15,370.64

Service Code	MSDRG 566
Min. Negotiated Rate	$7,685.32
Max. Negotiated Rate	$15,370.64
Rate for Payer: Aetna Medicare Advantage	$7,685.32
Rate for Payer: Cigna Commercial HMO & PPO	$7,685.32
Rate for Payer: Home State Health Plan Medicare Advantage	$7,685.32
Rate for Payer: Humana Commercial	$15,370.64
Rate for Payer: Humana Medicare Advantage	$7,685.32

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC

Facility

$36,229.80

Service Code	MSDRG 516
Min. Negotiated Rate	$18,114.90
Max. Negotiated Rate	$36,229.80
Rate for Payer: Aetna Medicare Advantage	$18,114.90
Rate for Payer: Cigna Commercial HMO & PPO	$18,114.90
Rate for Payer: Home State Health Plan Medicare Advantage	$18,114.90
Rate for Payer: Humana Commercial	$36,229.80
Rate for Payer: Humana Medicare Advantage	$18,114.90

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC

Facility

$53,744.06

Service Code	MSDRG 515
Min. Negotiated Rate	$26,872.03
Max. Negotiated Rate	$53,744.06
Rate for Payer: Aetna Medicare Advantage	$26,872.03
Rate for Payer: Cigna Commercial HMO & PPO	$26,872.03
Rate for Payer: Home State Health Plan Medicare Advantage	$26,872.03
Rate for Payer: Humana Commercial	$53,744.06
Rate for Payer: Humana Medicare Advantage	$26,872.03

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC

Facility

$27,700.68

Service Code	MSDRG 517
Min. Negotiated Rate	$13,850.34
Max. Negotiated Rate	$27,700.68
Rate for Payer: Aetna Medicare Advantage	$13,850.34
Rate for Payer: Cigna Commercial HMO & PPO	$13,850.34
Rate for Payer: Home State Health Plan Medicare Advantage	$13,850.34
Rate for Payer: Humana Commercial	$27,700.68
Rate for Payer: Humana Medicare Advantage	$13,850.34

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$40,613.20

Service Code	APR-DRG 3204
Min. Negotiated Rate	$40,613.20
Max. Negotiated Rate	$40,613.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$40,613.20
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$40,613.20
Rate for Payer: Home State Health Plan Medicaid Managed Care	$40,613.20
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$40,613.20

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$12,636.33

Service Code	APR-DRG 3201
Min. Negotiated Rate	$12,636.33
Max. Negotiated Rate	$12,636.33
Rate for Payer: Aetna Better Health Medicaid/QHP	$12,636.33
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$12,636.33
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12,636.33
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$12,636.33

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$21,802.01

Service Code	APR-DRG 3203
Min. Negotiated Rate	$21,802.01
Max. Negotiated Rate	$21,802.01
Rate for Payer: Aetna Better Health Medicaid/QHP	$21,802.01
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$21,802.01
Rate for Payer: Home State Health Plan Medicaid Managed Care	$21,802.01
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$21,802.01

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$14,010.16

Service Code	APR-DRG 3202
Min. Negotiated Rate	$14,010.16
Max. Negotiated Rate	$14,010.16
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,010.16
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,010.16
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,010.16
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,010.16

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC

Facility

$22,696.04

Service Code	MSDRG 844
Min. Negotiated Rate	$11,348.02
Max. Negotiated Rate	$22,696.04
Rate for Payer: Aetna Medicare Advantage	$11,348.02
Rate for Payer: Cigna Commercial HMO & PPO	$11,348.02
Rate for Payer: Home State Health Plan Medicare Advantage	$11,348.02
Rate for Payer: Humana Commercial	$22,696.04
Rate for Payer: Humana Medicare Advantage	$11,348.02

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC

Facility

$34,917.50

Service Code	MSDRG 843
Min. Negotiated Rate	$17,458.75
Max. Negotiated Rate	$34,917.50
Rate for Payer: Aetna Medicare Advantage	$17,458.75
Rate for Payer: Cigna Commercial HMO & PPO	$17,458.75
Rate for Payer: Home State Health Plan Medicare Advantage	$17,458.75
Rate for Payer: Humana Commercial	$34,917.50
Rate for Payer: Humana Medicare Advantage	$17,458.75

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC

Facility

$16,971.54

Service Code	MSDRG 845
Min. Negotiated Rate	$8,485.77
Max. Negotiated Rate	$16,971.54
Rate for Payer: Aetna Medicare Advantage	$8,485.77
Rate for Payer: Cigna Commercial HMO & PPO	$8,485.77
Rate for Payer: Home State Health Plan Medicare Advantage	$8,485.77
Rate for Payer: Humana Commercial	$16,971.54
Rate for Payer: Humana Medicare Advantage	$8,485.77

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$16,706.98

Service Code	APR-DRG 0261
Min. Negotiated Rate	$16,706.98
Max. Negotiated Rate	$16,706.98
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,706.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,706.98
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,706.98
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,706.98

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$45,367.07

Service Code	APR-DRG 0264
Min. Negotiated Rate	$45,367.07
Max. Negotiated Rate	$45,367.07
Rate for Payer: Aetna Better Health Medicaid/QHP	$45,367.07
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$45,367.07
Rate for Payer: Home State Health Plan Medicaid Managed Care	$45,367.07
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$45,367.07

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$28,721.11

Service Code	APR-DRG 0263
Min. Negotiated Rate	$28,721.11
Max. Negotiated Rate	$28,721.11
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,721.11
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,721.11
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,721.11
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,721.11

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$22,098.78

Service Code	APR-DRG 0262
Min. Negotiated Rate	$22,098.78
Max. Negotiated Rate	$22,098.78
Rate for Payer: Aetna Better Health Medicaid/QHP	$22,098.78
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22,098.78
Rate for Payer: Home State Health Plan Medicaid Managed Care	$22,098.78
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22,098.78

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$14,967.02

Service Code	APR-DRG 4253
Min. Negotiated Rate	$14,967.02
Max. Negotiated Rate	$14,967.02
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,967.02
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,967.02
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,967.02
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,967.02

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$28,755.62

Service Code	APR-DRG 4254
Min. Negotiated Rate	$28,755.62
Max. Negotiated Rate	$28,755.62
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,755.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,755.62
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,755.62
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,755.62

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$5,911.48

Service Code	APR-DRG 4251
Min. Negotiated Rate	$5,911.48
Max. Negotiated Rate	$5,911.48
Rate for Payer: Aetna Better Health Medicaid/QHP	$5,911.48
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5,911.48
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5,911.48
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5,911.48

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$7,232.81

Service Code	APR-DRG 4252
Min. Negotiated Rate	$7,232.81
Max. Negotiated Rate	$7,232.81
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,232.81
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,232.81
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,232.81
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,232.81

OTHER OPEN CRANIOTOMY

Facility

$9,217.45

Service Code	APR-DRG 0271
Min. Negotiated Rate	$9,217.45
Max. Negotiated Rate	$9,217.45
Rate for Payer: Aetna Better Health Medicaid/QHP	$9,217.45
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9,217.45
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9,217.45
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9,217.45

OTHER OPEN CRANIOTOMY

Facility

$28,982.75

Service Code	APR-DRG 0272
Min. Negotiated Rate	$28,982.75
Max. Negotiated Rate	$28,982.75
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,982.75
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,982.75
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,982.75
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,982.75

Know your out-of-pocket cost for care.

All Charges