Madison Medical Center

All Charges

Charge

Type

Setting

Price

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$28,561.17

Service Code	APR-DRG 1773
Min. Negotiated Rate	$28,561.17
Max. Negotiated Rate	$28,561.17
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,561.17
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,561.17
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,561.17
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,561.17

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$18,167.72

Service Code	APR-DRG 1772
Min. Negotiated Rate	$18,167.72
Max. Negotiated Rate	$18,167.72
Rate for Payer: Aetna Better Health Medicaid/QHP	$18,167.72
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$18,167.72
Rate for Payer: Home State Health Plan Medicaid Managed Care	$18,167.72
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$18,167.72

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$15,699.26

Service Code	APR-DRG 1771
Min. Negotiated Rate	$15,699.26
Max. Negotiated Rate	$15,699.26
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,699.26
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,699.26
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,699.26
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,699.26

CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC

Facility

$53,035.32

Service Code	MSDRG 258
Min. Negotiated Rate	$26,517.66
Max. Negotiated Rate	$53,035.32
Rate for Payer: Aetna Medicare Advantage	$26,517.66
Rate for Payer: Cigna Commercial HMO & PPO	$26,517.66
Rate for Payer: Home State Health Plan Medicare Advantage	$26,517.66
Rate for Payer: Humana Commercial	$53,035.32
Rate for Payer: Humana Medicare Advantage	$26,517.66

CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC

Facility

$35,347.56

Service Code	MSDRG 259
Min. Negotiated Rate	$17,673.78
Max. Negotiated Rate	$35,347.56
Rate for Payer: Aetna Medicare Advantage	$17,673.78
Rate for Payer: Cigna Commercial HMO & PPO	$17,673.78
Rate for Payer: Home State Health Plan Medicare Advantage	$17,673.78
Rate for Payer: Humana Commercial	$35,347.56
Rate for Payer: Humana Medicare Advantage	$17,673.78

CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC

Facility

$33,274.40

Service Code	MSDRG 261
Min. Negotiated Rate	$16,637.20
Max. Negotiated Rate	$33,274.40
Rate for Payer: Aetna Medicare Advantage	$16,637.20
Rate for Payer: Cigna Commercial HMO & PPO	$16,637.20
Rate for Payer: Home State Health Plan Medicare Advantage	$16,637.20
Rate for Payer: Humana Commercial	$33,274.40
Rate for Payer: Humana Medicare Advantage	$16,637.20

CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC

Facility

$54,786.60

Service Code	MSDRG 260
Min. Negotiated Rate	$27,393.30
Max. Negotiated Rate	$54,786.60
Rate for Payer: Aetna Medicare Advantage	$27,393.30
Rate for Payer: Cigna Commercial HMO & PPO	$27,393.30
Rate for Payer: Home State Health Plan Medicare Advantage	$27,393.30
Rate for Payer: Humana Commercial	$54,786.60
Rate for Payer: Humana Medicare Advantage	$27,393.30

CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC

Facility

$29,168.96

Service Code	MSDRG 262
Min. Negotiated Rate	$14,584.48
Max. Negotiated Rate	$29,168.96
Rate for Payer: Aetna Medicare Advantage	$14,584.48
Rate for Payer: Cigna Commercial HMO & PPO	$14,584.48
Rate for Payer: Home State Health Plan Medicare Advantage	$14,584.48
Rate for Payer: Humana Commercial	$29,168.96
Rate for Payer: Humana Medicare Advantage	$14,584.48

CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$28,782.13

Service Code	APR-DRG 2004
Min. Negotiated Rate	$28,782.13
Max. Negotiated Rate	$28,782.13
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,782.13
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,782.13
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,782.13
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,782.13

CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$8,489.86

Service Code	APR-DRG 2001
Min. Negotiated Rate	$8,489.86
Max. Negotiated Rate	$8,489.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,489.86
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,489.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,489.86
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,489.86

CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$28,782.13

Service Code	APR-DRG 2002
Min. Negotiated Rate	$28,782.13
Max. Negotiated Rate	$28,782.13
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,782.13
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,782.13
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,782.13
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,782.13

CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$28,782.13

Service Code	APR-DRG 2003
Min. Negotiated Rate	$28,782.13
Max. Negotiated Rate	$28,782.13
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,782.13
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,782.13
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,782.13
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,782.13

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC

Facility

$107,515.10

Service Code	MSDRG 217
Min. Negotiated Rate	$53,757.55
Max. Negotiated Rate	$107,515.10
Rate for Payer: Aetna Medicare Advantage	$53,757.55
Rate for Payer: Cigna Commercial HMO & PPO	$53,757.55
Rate for Payer: Home State Health Plan Medicare Advantage	$53,757.55
Rate for Payer: Humana Commercial	$107,515.10
Rate for Payer: Humana Medicare Advantage	$53,757.55

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$158,433.12

Service Code	MSDRG 216
Min. Negotiated Rate	$79,216.56
Max. Negotiated Rate	$158,433.12
Rate for Payer: Aetna Medicare Advantage	$79,216.56
Rate for Payer: Cigna Commercial HMO & PPO	$79,216.56
Rate for Payer: Home State Health Plan Medicare Advantage	$79,216.56
Rate for Payer: Humana Commercial	$158,433.12
Rate for Payer: Humana Medicare Advantage	$79,216.56

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$107,515.10

Service Code	MSDRG 218
Min. Negotiated Rate	$53,757.55
Max. Negotiated Rate	$107,515.10
Rate for Payer: Aetna Medicare Advantage	$53,757.55
Rate for Payer: Cigna Commercial HMO & PPO	$53,757.55
Rate for Payer: Home State Health Plan Medicare Advantage	$53,757.55
Rate for Payer: Humana Commercial	$107,515.10
Rate for Payer: Humana Medicare Advantage	$53,757.55

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC

Facility

$87,790.82

Service Code	MSDRG 220
Min. Negotiated Rate	$43,895.41
Max. Negotiated Rate	$87,790.82
Rate for Payer: Aetna Medicare Advantage	$43,895.41
Rate for Payer: Cigna Commercial HMO & PPO	$43,895.41
Rate for Payer: Home State Health Plan Medicare Advantage	$43,895.41
Rate for Payer: Humana Commercial	$87,790.82
Rate for Payer: Humana Medicare Advantage	$43,895.41

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC

Facility

$125,024.86

Service Code	MSDRG 219
Min. Negotiated Rate	$62,512.43
Max. Negotiated Rate	$125,024.86
Rate for Payer: Aetna Medicare Advantage	$62,512.43
Rate for Payer: Cigna Commercial HMO & PPO	$62,512.43
Rate for Payer: Home State Health Plan Medicare Advantage	$62,512.43
Rate for Payer: Humana Commercial	$125,024.86
Rate for Payer: Humana Medicare Advantage	$62,512.43

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$83,145.90

Service Code	MSDRG 221
Min. Negotiated Rate	$41,572.95
Max. Negotiated Rate	$83,145.90
Rate for Payer: Aetna Medicare Advantage	$41,572.95
Rate for Payer: Cigna Commercial HMO & PPO	$41,572.95
Rate for Payer: Home State Health Plan Medicare Advantage	$41,572.95
Rate for Payer: Humana Commercial	$83,145.90
Rate for Payer: Humana Medicare Advantage	$41,572.95

CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$123,018.35

Service Code	APR-DRG 1624
Min. Negotiated Rate	$123,018.35
Max. Negotiated Rate	$123,018.35
Rate for Payer: Aetna Better Health Medicaid/QHP	$123,018.35
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$123,018.35
Rate for Payer: Home State Health Plan Medicaid Managed Care	$123,018.35
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$123,018.35

CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$48,509.51

Service Code	APR-DRG 1621
Min. Negotiated Rate	$48,509.51
Max. Negotiated Rate	$48,509.51
Rate for Payer: Aetna Better Health Medicaid/QHP	$48,509.51
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$48,509.51
Rate for Payer: Home State Health Plan Medicaid Managed Care	$48,509.51
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$48,509.51

CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$75,136.58

Service Code	APR-DRG 1623
Min. Negotiated Rate	$75,136.58
Max. Negotiated Rate	$75,136.58
Rate for Payer: Aetna Better Health Medicaid/QHP	$75,136.58
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$75,136.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$75,136.58
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$75,136.58

CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$56,996.60

Service Code	APR-DRG 1622
Min. Negotiated Rate	$56,996.60
Max. Negotiated Rate	$56,996.60
Rate for Payer: Aetna Better Health Medicaid/QHP	$56,996.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$56,996.60
Rate for Payer: Home State Health Plan Medicaid Managed Care	$56,996.60
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$56,996.60

CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$56,217.23

Service Code	APR-DRG 1633
Min. Negotiated Rate	$56,217.23
Max. Negotiated Rate	$56,217.23
Rate for Payer: Aetna Better Health Medicaid/QHP	$56,217.23
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$56,217.23
Rate for Payer: Home State Health Plan Medicaid Managed Care	$56,217.23
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$56,217.23

CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$96,995.91

Service Code	APR-DRG 1634
Min. Negotiated Rate	$96,995.91
Max. Negotiated Rate	$96,995.91
Rate for Payer: Aetna Better Health Medicaid/QHP	$96,995.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$96,995.91
Rate for Payer: Home State Health Plan Medicaid Managed Care	$96,995.91
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$96,995.91

CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$35,662.40

Service Code	APR-DRG 1632
Min. Negotiated Rate	$35,662.40
Max. Negotiated Rate	$35,662.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$35,662.40
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$35,662.40
Rate for Payer: Home State Health Plan Medicaid Managed Care	$35,662.40
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$35,662.40

Know your out-of-pocket cost for care.

All Charges