Madison Medical Center

All Charges

Charge

Type

Setting

Price

OTHER PNEUMONIA

Facility

$14,348.14

Service Code	APR-DRG 1393
Min. Negotiated Rate	$14,348.14
Max. Negotiated Rate	$14,348.14
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,348.14
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,348.14
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,348.14
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,348.14

OTHER PNEUMONIA

Facility

$5,298.65

Service Code	APR-DRG 1391
Min. Negotiated Rate	$5,298.65
Max. Negotiated Rate	$5,298.65
Rate for Payer: Aetna Better Health Medicaid/QHP	$5,298.65
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5,298.65
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5,298.65
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5,298.65

OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$22,611.89

Service Code	APR-DRG 4053
Min. Negotiated Rate	$22,611.89
Max. Negotiated Rate	$22,611.89
Rate for Payer: Aetna Better Health Medicaid/QHP	$22,611.89
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22,611.89
Rate for Payer: Home State Health Plan Medicaid Managed Care	$22,611.89
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22,611.89

OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$50,820.81

Service Code	APR-DRG 4054
Min. Negotiated Rate	$50,820.81
Max. Negotiated Rate	$50,820.81
Rate for Payer: Aetna Better Health Medicaid/QHP	$50,820.81
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$50,820.81
Rate for Payer: Home State Health Plan Medicaid Managed Care	$50,820.81
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$50,820.81

OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$16,775.40

Service Code	APR-DRG 4051
Min. Negotiated Rate	$16,775.40
Max. Negotiated Rate	$16,775.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,775.40
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,775.40
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,775.40
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,775.40

OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$16,775.40

Service Code	APR-DRG 4052
Min. Negotiated Rate	$16,775.40
Max. Negotiated Rate	$16,775.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,775.40
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,775.40
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,775.40
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,775.40

OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$21,017.09

Service Code	APR-DRG 6512
Min. Negotiated Rate	$21,017.09
Max. Negotiated Rate	$21,017.09
Rate for Payer: Aetna Better Health Medicaid/QHP	$21,017.09
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$21,017.09
Rate for Payer: Home State Health Plan Medicaid Managed Care	$21,017.09
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$21,017.09

OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$25,144.14

Service Code	APR-DRG 6513
Min. Negotiated Rate	$25,144.14
Max. Negotiated Rate	$25,144.14
Rate for Payer: Aetna Better Health Medicaid/QHP	$25,144.14
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$25,144.14
Rate for Payer: Home State Health Plan Medicaid Managed Care	$25,144.14
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$25,144.14

OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$14,869.04

Service Code	APR-DRG 6511
Min. Negotiated Rate	$14,869.04
Max. Negotiated Rate	$14,869.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,869.04
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,869.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,869.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,869.04

OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$53,301.29

Service Code	APR-DRG 6514
Min. Negotiated Rate	$53,301.29
Max. Negotiated Rate	$53,301.29
Rate for Payer: Aetna Better Health Medicaid/QHP	$53,301.29
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$53,301.29
Rate for Payer: Home State Health Plan Medicaid Managed Care	$53,301.29
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$53,301.29

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$23,117.60

Service Code	APR-DRG 1212
Min. Negotiated Rate	$23,117.60
Max. Negotiated Rate	$23,117.60
Rate for Payer: Aetna Better Health Medicaid/QHP	$23,117.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$23,117.60
Rate for Payer: Home State Health Plan Medicaid Managed Care	$23,117.60
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$23,117.60

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$38,904.68

Service Code	APR-DRG 1213
Min. Negotiated Rate	$38,904.68
Max. Negotiated Rate	$38,904.68
Rate for Payer: Aetna Better Health Medicaid/QHP	$38,904.68
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$38,904.68
Rate for Payer: Home State Health Plan Medicaid Managed Care	$38,904.68
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$38,904.68

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$10,830.74

Service Code	APR-DRG 1211
Min. Negotiated Rate	$10,830.74
Max. Negotiated Rate	$10,830.74
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,830.74
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,830.74
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,830.74
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,830.74

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$57,579.04

Service Code	APR-DRG 1214
Min. Negotiated Rate	$57,579.04
Max. Negotiated Rate	$57,579.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$57,579.04
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$57,579.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$57,579.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$57,579.04

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$16,755.84

Service Code	APR-DRG 1433
Min. Negotiated Rate	$16,755.84
Max. Negotiated Rate	$16,755.84
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,755.84
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,755.84
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,755.84
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,755.84

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$8,951.39

Service Code	APR-DRG 1431
Min. Negotiated Rate	$8,951.39
Max. Negotiated Rate	$8,951.39
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,951.39
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,951.39
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,951.39
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,951.39

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$25,841.67

Service Code	APR-DRG 1434
Min. Negotiated Rate	$25,841.67
Max. Negotiated Rate	$25,841.67
Rate for Payer: Aetna Better Health Medicaid/QHP	$25,841.67
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$25,841.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$25,841.67
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$25,841.67

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$11,311.86

Service Code	APR-DRG 1432
Min. Negotiated Rate	$11,311.86
Max. Negotiated Rate	$11,311.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$11,311.86
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11,311.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11,311.86
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11,311.86

OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC

Facility

$32,337.02

Service Code	MSDRG 205
Min. Negotiated Rate	$16,168.51
Max. Negotiated Rate	$32,337.02
Rate for Payer: Aetna Medicare Advantage	$16,168.51
Rate for Payer: Cigna Commercial HMO & PPO	$16,168.51
Rate for Payer: Home State Health Plan Medicare Advantage	$16,168.51
Rate for Payer: Humana Commercial	$32,337.02
Rate for Payer: Humana Medicare Advantage	$16,168.51

OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC

Facility

$18,372.12

Service Code	MSDRG 206
Min. Negotiated Rate	$9,186.06
Max. Negotiated Rate	$18,372.12
Rate for Payer: Aetna Medicare Advantage	$9,186.06
Rate for Payer: Cigna Commercial HMO & PPO	$9,186.06
Rate for Payer: Home State Health Plan Medicare Advantage	$9,186.06
Rate for Payer: Humana Commercial	$18,372.12
Rate for Payer: Humana Medicare Advantage	$9,186.06

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC

Facility

$31,902.24

Service Code	MSDRG 167
Min. Negotiated Rate	$15,951.12
Max. Negotiated Rate	$31,902.24
Rate for Payer: Aetna Medicare Advantage	$15,951.12
Rate for Payer: Cigna Commercial HMO & PPO	$15,951.12
Rate for Payer: Home State Health Plan Medicare Advantage	$15,951.12
Rate for Payer: Humana Commercial	$31,902.24
Rate for Payer: Humana Medicare Advantage	$15,951.12

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC

Facility

$62,475.28

Service Code	MSDRG 166
Min. Negotiated Rate	$31,237.64
Max. Negotiated Rate	$62,475.28
Rate for Payer: Aetna Medicare Advantage	$31,237.64
Rate for Payer: Cigna Commercial HMO & PPO	$31,237.64
Rate for Payer: Home State Health Plan Medicare Advantage	$31,237.64
Rate for Payer: Humana Commercial	$62,475.28
Rate for Payer: Humana Medicare Advantage	$31,237.64

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

Facility

$25,028.42

Service Code	MSDRG 168
Min. Negotiated Rate	$12,514.21
Max. Negotiated Rate	$25,028.42
Rate for Payer: Aetna Medicare Advantage	$12,514.21
Rate for Payer: Cigna Commercial HMO & PPO	$12,514.21
Rate for Payer: Home State Health Plan Medicare Advantage	$12,514.21
Rate for Payer: Humana Commercial	$25,028.42
Rate for Payer: Humana Medicare Advantage	$12,514.21

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$24,664.32

Service Code	APR-DRG 3093
Min. Negotiated Rate	$24,664.32
Max. Negotiated Rate	$24,664.32
Rate for Payer: Aetna Better Health Medicaid/QHP	$24,664.32
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$24,664.32
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24,664.32
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$24,664.32

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$14,995.70

Service Code	APR-DRG 3092
Min. Negotiated Rate	$14,995.70
Max. Negotiated Rate	$14,995.70
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,995.70
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,995.70
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,995.70
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,995.70

Know your out-of-pocket cost for care.

All Charges