Pontiac, IL, 61764
The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.
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vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | vs nat'l | Neg max |
|---|---|---|---|---|---|---|---|---|---|
| behavioral | |||||||||
| Psychoses | MS-DRG | 885 | 10 | — | — | $70 | $11,090 | 0.87× | $24,183 |
| inpatient | |||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 10 | — | — | $70 | $15,966 | 0.79× | $35,449 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 10 | — | — | $70 | $8,021 | 0.75× | $17,988 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 10 | — | — | $70 | $5,433.6 | 0.71× | $12,167 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 10 | — | — | $70 | $12,407 | 0.80× | $30,023 |
| COPD w MCC | MS-DRG | 190 | 10 | — | — | $70 | $8,794.27 | 0.78× | $19,503 |
| COPD w CC | MS-DRG | 191 | 10 | — | — | $70 | $6,692.76 | 0.76× | $15,026 |
| COPD w/o CC/MCC | MS-DRG | 192 | 10 | — | — | $70 | $5,096.98 | 0.73× | $11,359 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 10 | — | — | $70 | $6,398.22 | 0.75× | $14,551 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 10 | — | — | $70 | $4,989.8 | 0.75× | $11,072 |
| AMI discharged alive w MCC | MS-DRG | 280 | 10 | — | — | $70 | $12,735 | 0.81× | $28,078 |
| AMI discharged alive w CC | MS-DRG | 281 | 10 | — | — | $70 | $7,296.94 | 0.75× | $16,158 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 10 | — | — | $70 | $5,740.85 | 0.74× | $12,709 |
| Heart failure & shock w MCC | MS-DRG | 291 | 10 | — | — | $70 | $10,192 | 0.80× | $22,722 |
| Heart failure & shock w CC | MS-DRG | 292 | 10 | — | — | $70 | $6,740.4 | 0.75× | $15,158 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 10 | — | — | $70 | $4,493.6 | 0.72× | $9,937.43 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 10 | — | — | $70 | $9,558.82 | 0.79× | $21,277 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 10 | — | — | $70 | $5,840.88 | 0.75× | $13,180 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 10 | — | — | $70 | $4,494.39 | 0.72× | $9,786.99 |
| GI hemorrhage w CC | MS-DRG | 378 | 10 | — | — | $70 | $7,785.99 | 0.78× | $17,411 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 10 | — | — | $70 | $5,004.88 | 0.73× | $11,206 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 10 | — | — | $70 | $6,189.42 | 0.77× | $13,904 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 10 | — | — | $70 | $12,446 | 0.82× | $28,873 |
| Kidney/UTI w MCC | MS-DRG | 689 | 10 | — | — | $70 | $9,211.88 | 0.79× | $20,785 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 10 | — | — | $70 | $6,426.8 | 0.77× | $14,281 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 10 | — | — | $70 | $15,422 | 0.83× | $35,088 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 10 | — | — | $70 | $8,124.21 | 0.78× | $18,227 |
| maternity | |||||||||
| Cesarean section w CC/MCC | MS-DRG | 765 | 2 | — | — | $70 | $71.1 | 0.79× | $72.2 |
| Cesarean section w/o CC/MCC | MS-DRG | 766 | 2 | — | — | $70 | $71.1 | 0.79× | $72.2 |
| Vaginal delivery w complicating dx | MS-DRG | 774 | 2 | — | — | $70 | $71.1 | 0.77× | $72.2 |
| Vaginal delivery w/o complicating dx | MS-DRG | 775 | 2 | — | — | $70 | $71.1 | 0.08× | $72.2 |
| surgery | |||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 3 | — | — | $70 | $72.2 | 0.00× | $53,013 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 3 | — | — | $70 | $72.2 | 0.00× | $33,794 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 10 | — | — | $70 | $36,493 | 0.85× | $79,938 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 10 | — | — | $70 | $19,032 | 0.82× | $41,981 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 10 | — | — | $70 | $13,361 | 0.81× | $29,591 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 10 | — | — | $70 | $13,430 | 0.81× | $28,931 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 10 | — | — | $70 | $10,843 | 0.80× | $23,241 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 10 | — | — | $70 | $27,050 | 0.84× | $56,648 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 3 | — | — | $70 | $72.2 | 0.00× | $117,378 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 3 | — | — | $70 | $72.2 | 0.00× | $64,738 |
| Major joint replacement w MCC | MS-DRG | 469 | 10 | — | — | $70 | $24,081 | 0.81× | $58,931 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 10 | — | — | $70 | $15,314 | 0.81× | $33,302 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 10 | — | — | $70 | $23,121 | 0.83× | $52,190 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 10 | — | — | $70 | $16,629 | 0.82× | $36,722 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 10 | — | — | $70 | $12,949 | 0.81× | $28,112 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 10 | — | — | $70 | $22,924 | 0.84× | $46,059 |
| OR procedure for obesity w CC | MS-DRG | 620 | 10 | — | — | $70 | $12,705 | 0.78× | $28,710 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 10 | — | — | $70 | $11,976 | 0.79× | $26,853 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 10 | — | — | $70 | $9,850.19 | 0.80× | $20,565 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 10 | — | — | $70 | $16,268 | 0.85× | $33,315 |
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 51 | $72.2 |
| Aetna | 51 | $70 |
| health alliance plan | 47 | $15,160 |
| Humana | 43 | $10,091 |
| meridian | 43 | $10,091 |
| Molina | 43 | $10,091 |
| va ccn | 43 | $10,091 |
| WellCare | 43 | $10,192 |
| Blue Cross Blue Shield | 43 | $12,700 |
| caterpillar | 43 | $20,072 |
